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NPI Code Detail

MEDICARE: CARLO BRUNO BIFULCO MD

MEDICARE: CARLO BRUNO BIFULCO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0101XAnatomic Pathology Physician041504CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528057155
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLO BRUNO BIFULCO MD
Provider Business Mailing Address
First Line : PO BOX 9805
Second Line : 300 GEORGE ST 6TH FLOOR
City : NEW HAVEN
State : CT
Zip : 06536-0805
Country : US
Telephone Number : 203-785-7998
Fax Number :
Provider Business Practice Location Address
First Line : 20 YORK ST
Second Line : YALE-NEW HAVEN CHILDREN'S HOSPITAL-EP 2608
City : NEW HAVEN
State : CT
Zip : 06510-3220
Country : US
Telephone Number : 203-785-3624
Fax Number : 203-785-7037
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 05/22/2008

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