Individual
DR. TITO L. VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 POST RD, SOUTHPORT, CT 06890-1258
(203) 292-8119
(203) 292-8120
Mailing address
2600 POST RD, SOUTHPORT, CT 06890-1258
(203) 292-8119
(203) 292-8120
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
046169
CT
2086S0105X
Surgery of the Hand (Surgery) Physician
046169
CT
2086S0122X
Plastic and Reconstructive Surgery Physician
046169
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D300000073
MEDICARE PTAN
CT
Enumeration date
04/28/2008
Last updated
02/02/2012
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