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Individual

IRENE NASADUKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

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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