Individual
JUDITH VICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(410) 236-0650
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(410) 236-0650
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2022-02137
NC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
79519
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/05/2016
Last updated
10/16/2024
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