Individual
DR. VASUDHA VALLABHANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3180 MAIN ST, SUITE 301, BRIDGEPORT, CT 06606-4237
(203) 373-9100
(203) 365-8492
Mailing address
3180 MAIN ST, SUITE 301, BRIDGEPORT, CT 06606-4237
(203) 373-9100
(203) 365-8492
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036272
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001362722
—
CT
Enumeration date
03/21/2006
Last updated
05/31/2013
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