Healthcare Provider Details

I. General information

NPI: 1942263033
Provider Name (Legal Business Name): CHAULA K. VORA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 RIVER RD STE 101
COS COB CT
06807-2759
US

IV. Provider business mailing address

35 RIVER RD STE 101
COS COB CT
06807-2759
US

V. Phone/Fax

Practice location:
  • Phone: 203-863-4750
  • Fax: 203-863-4580
Mailing address:
  • Phone: 203-863-4750
  • Fax: 203-863-4580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number041842
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: