Individual
DR. MARGO L. FUGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
226 DIXWELL AVENUE, CFG-DIXWELL, NEW HAVEN, CT 06511-3456
(203) 503-3458
(203) 503-3451
Mailing address
400 COLUMBUS AVENUE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3174
(203) 503-3183
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
61909
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
08/22/2006
Last updated
10/04/2018
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