Healthcare Provider Details

I. General information

NPI: 1740576016
Provider Name (Legal Business Name): LOREDANA CHRISTINE CUCCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 E ROCKS RD HOUSE A
NORWALK CT
06851-1726
US

IV. Provider business mailing address

179 E ROCKS RD HOUSE A
NORWALK CT
06851-1726
US

V. Phone/Fax

Practice location:
  • Phone: 203-286-8984
  • Fax: 203-286-8984
Mailing address:
  • Phone: 203-286-8984
  • Fax: 203-286-8984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number037950
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: