Individual
NECLA KUDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 CHURCH ST S STE F206, NEW HAVEN, CT 06519-1703
(203) 785-3141
(203) 785-2510
Mailing address
47 NUTMEG DR, GREENWICH, CT 06831-3211
(718) 690-0439
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
276495
NY
2080N0001X
Neonatal-Perinatal Medicine Physician
CT47008
CT
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD456462
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03380178
—
NY
05
—
1031318040001
—
PA
01
—
547875PZP
MEDICARE
PA
01
—
A400056573
MEDICARE PTAN
NY
Enumeration date
07/28/2011
Last updated
02/16/2022
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