Individual
ADA VIDAL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
471 BARNUM AVE, BRIDGEPORT, CT 06608-2409
(203) 333-6864
(203) 332-0376
Mailing address
471 BARNUM AVE, BRIDGEPORT, CT 06608-2409
(203) 333-6864
(203) 332-0376
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
040373
CT
Other
Enumeration date
07/19/2005
Last updated
07/08/2007
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