Healthcare Provider Details

I. General information

NPI: 1912988916
Provider Name (Legal Business Name): CARIN MORSE VANGELDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HOSPITAL HILL RD
SHARON CT
06069-2096
US

IV. Provider business mailing address

2800 MAIN ST
BRIDGEPORT CT
06606-4201
US

V. Phone/Fax

Practice location:
  • Phone: 860-364-4034
  • Fax:
Mailing address:
  • Phone: 475-210-5604
  • Fax: 475-210-6368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number038049
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: