Individual
KUMUDHINI FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
687 CAMPBELL AVE, WEST HAVEN, CT 06516-3774
(203) 932-6481
(203) 932-4051
Mailing address
687 CAMPBELL AVE, WEST HAVEN, CT 06516-3774
(203) 932-6481
(203) 932-4051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
016797
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001167972
RAILROAD MEDICARE
CT
05
—
001167972
—
CT
01
—
010016797CT01
ANTHEM BLUE SHIELD
CT
01
—
016797
CONNECTICARE
CT
01
—
0V7684
HEALTHNET
CT
01
—
2671960
AETNA
CT
01
—
P778776
OXFORD
CT
Enumeration date
06/27/2005
Last updated
12/04/2012
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