Individual
DR. STACEY A BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 298-8967
Mailing address
PO BOX 208042, NEW HAVEN, CT 06520-8042
(203) 298-8967
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
052849
CT
2085R0204X
Vascular & Interventional Radiology Physician
Primary
052849
CT
Other
Enumeration date
07/08/2008
Last updated
11/14/2022
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