Individual
ADAM SAMUEL FEDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 QUARRY ROAD, 56 QUARRY ROAD, TRUMBULL, CT 06611-1351
(203) 696-3672
(203) 696-6130
Mailing address
3 ENTERPRISE DR, STE 220, SHELTON, CT 06484-4694
(203) 696-3670
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
046746
CT
2085R0204X
Vascular & Interventional Radiology Physician
046746
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02950461
—
NY
05
—
500000187
—
CT
05
—
7953500
—
NJ
Enumeration date
12/02/2005
Last updated
04/03/2017
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