Widroff, Michael Andrew

Widroff, Michael Andrew is an sole proprietor health care provider with primary practice located at 1 Wahoo Ave , Groton CT 06349-2324. He recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Cognitive & Behavioral. Behavioral Health & Social Service Providers / Cognitive & Behavioral is his primary health care specialty. Widroff, Michael Andrew can be contacted via phone (860) 694-4966.

Contact Information

Primary practice address
1 Wahoo Ave Groton CT 06349-2324
Phone: (860) 694-4966
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X

Profile Details

NPI number 1528433877
LBN Legal business name Widroff, Michael Andrew
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 10th, 2015
Last updated Apr 12th, 2018 - about 7 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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