Healthcare Provider Details

I. General information

NPI: 1568805125
Provider Name (Legal Business Name): FRANCESCO PELUSO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LOCK ST
NEW HAVEN CT
06511-3603
US

IV. Provider business mailing address

291 WHITNEY AVE STE 201
NEW HAVEN CT
06511-3762
US

V. Phone/Fax

Practice location:
  • Phone: 203-432-0290
  • Fax: 203-432-8458
Mailing address:
  • Phone: 203-200-0704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number54299
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number54299
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: