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General NPI Number Information
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NPI Number | 1659604528
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Entity Type | Individual
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Provider Name | VASUNDARA TUMMALA M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 01/10/2020
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Provider Practice Location Address
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Address Line | 120 CONNECTICUT AVE
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City | NORWALK
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State | CT
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Zip | 06854-1525
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Country | US
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Telephone | 203-899-1770
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Fax | 203-852-3982
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Provider Business Mailing Address
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Address Line | 16 CRANBURY RD
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City | WESTPORT
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State | CT
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Zip | 06880-1814
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Country | US
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Telephone | 678-521-0478
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 047836
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License Number State | CT
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