Provider Demographics
NPI:1043569288
Name:PORRINO, DAVID (PSYD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:PORRINO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 OLD KINGS HWY N FL 2
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4732
Mailing Address - Country:US
Mailing Address - Phone:203-202-7654
Mailing Address - Fax:
Practice Address - Street 1:85 OLD KINGS HWY N FL 2
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4732
Practice Address - Country:US
Practice Address - Phone:203-202-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3873103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist