Fox, Gary John

Fox, Gary John is an individual health care provider with primary practice located at 501 Ocean Ave , New London CT 06320. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fox, Gary John can be contacted via phone (860) 442-6364.

Contact Information

Primary practice address
501 Ocean Ave New London CT 06320
Phone: (860) 442-6364
Fax: (860) 447-9977
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1508814765
LBN Legal business name Fox, Gary John
Credentials MSW LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jun 26th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508814765 NPPES
Connecticut MEDICAID 004150455

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