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Individual

DR. SCOTT ALAN VANDER VENNET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2 IVY BROOK RD STE 125, SHELTON, CT 06484-6416
(203) 954-0080
(203) 954-0084
Mailing address
67 MAPLE AVE, DERBY, CT 06418-1328
(203) 732-1256
(203) 732-1539

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
37036
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001390369
CT
Enumeration date
06/30/2006
Last updated
03/07/2023
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