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Individual

DR. MARILYN M VINOKUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
1211 W MAIN ST, WATERBURY, CT 06708-3106
(203) 755-2050
(203) 755-0131
Mailing address
1211 W MAIN ST, WATERBURY, CT 06708-3106
(203) 755-2050
(203) 755-0131

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000215
CT
213ES0131X
Foot Surgery Podiatrist
Primary
CT000215
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004068821(GROUP)
CT
01
030000215CT01
BLUECROSS/BLUESHIELD
CT
01
061060793
TAX ID
CT
01
061060793008
CIGNA
CT
01
29528
WELLCARE
CT
01
508832
AETNA
CT
01
760793
CONNECTICARE
CT
01
NHS335
OXFORD
CT
01
OR0932
ACS HEALTHNET
CT
01
PBW42
EMPIRE BC
NY
Enumeration date
05/10/2006
Last updated
08/21/2012
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