Individual
BHUPESH MANGLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1450 CHAPEL ST, DEPARTMENT OF MEDICINE, HOSPITAL OF SAINT RAPHAEL, NEW HAVEN, CT 06511-4405
(203) 789-3203
(203) 789-3222
Mailing address
226 MILL HILL AVE., 3RD FL., BRIDGEPORT, CT 06610
(203) 272-2248
(203) 272-9690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040017
CT
2083P0901X
Public Health & General Preventive Medicine Physician
040017
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001400176
—
CT
Enumeration date
06/01/2005
Last updated
09/08/2017
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