Healthcare Provider Details

I. General information

NPI: 1396743753
Provider Name (Legal Business Name): STEVEN D VYCE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CAMPBELL AVE VACT, MS 112
WEST HAVEN CT
06516-2770
US

IV. Provider business mailing address

330 ORCHARD ST STE 207
NEW HAVEN CT
06511-4429
US

V. Phone/Fax

Practice location:
  • Phone: 203-444-0309
  • Fax: 203-937-3845
Mailing address:
  • Phone: 203-789-3443
  • Fax: 203-867-5488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005856-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberMD002431
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number822
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: