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General NPI Number Information
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NPI Number | 1407141328
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Entity Type | Individual
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Provider Name | GABRIELA ZAGARODNE SPILBERG MISSINE M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 333 CEDAR ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3206
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Country | US
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Telephone | 203-605-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 15 LEDYARD RD
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City | WEST HARTFORD
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State | CT
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Zip | 06117-1712
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Country | US
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Telephone | 617-775-4464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 249237
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 66162
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License Number State | CT
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