Individual
DR. SEUNG-YEUN WAITZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D,
Contact information
Practice address
22 POVERTY RD, SOUTHBURY, CT 06488-2254
(203) 262-6200
(203) 262-6205
Mailing address
PO BOX 82, SOUTHBURY, CT 06488-0082
(203) 262-6200
(203) 262-6205
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
038906
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001389065
—
CT
Enumeration date
04/18/2006
Last updated
12/18/2012
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