Healthcare Provider Details

I. General information

NPI: 1952807026
Provider Name (Legal Business Name): LIFAN HSU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL PLZ
STAMFORD CT
06902-3602
US

IV. Provider business mailing address

1 HOSPITAL PLZ
STAMFORD CT
06902-3602
US

V. Phone/Fax

Practice location:
  • Phone: 203-276-7298
  • Fax: 203-276-4842
Mailing address:
  • Phone: 203-276-7298
  • Fax: 203-276-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number69191
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number69191
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: