Healthcare Provider Details

I. General information

NPI: 1013907476
Provider Name (Legal Business Name): MARIAN E VULPE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 WHITNEY AVE STE 180
HAMDEN CT
06518-3691
US

IV. Provider business mailing address

2200 WHITNEY AVE STE 180
HAMDEN CT
06518-3691
US

V. Phone/Fax

Practice location:
  • Phone: 203-407-2500
  • Fax: 203-407-5812
Mailing address:
  • Phone: 203-407-2500
  • Fax: 203-407-5812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number043382
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: