Individual
IRENE NASADUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1150 SUMMER STREET, STAMFORD, CT 06905-5530
(203) 357-0770
Mailing address
1150 SUMMER STREET, STAMFORD, CT 06905-5530
(203) 357-0770
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
028817
CT
208D00000X
General Practice Physician
028817
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001288176
—
CT
01
—
0100Z8817C701
ANTHEM
—
Enumeration date
03/01/2007
Last updated
10/05/2010
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