Provider Demographics
NPI:1043353337
Name:STUTZ, ELEANOR ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ELIZABETH
Last Name:STUTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELEANOR
Other - Middle Name:ELIZABETH
Other - Last Name:MAIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:95 THOMASTON AVE
Mailing Address - Street 2:DMHAS - WCMHN
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1007
Mailing Address - Country:US
Mailing Address - Phone:203-805-5300
Mailing Address - Fax:203-805-5310
Practice Address - Street 1:95 THOMASTON AVE
Practice Address - Street 2:DMHAS - WCMHN
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1007
Practice Address - Country:US
Practice Address - Phone:203-805-5300
Practice Address - Fax:203-805-5310
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0259152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry