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Individual

DR. FEDERICO E. VACA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-2222
(203) 688-3027
Mailing address
464 CONGRESS AVE, SUITE 260, NEW HAVEN, CT 06519-1361
(203) 785-2353
(203) 785-4580

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
000000A52737
CA
207P00000X
Emergency Medicine Physician
Primary
047775
CT
207PS0010X
Sports Medicine (Emergency Medicine) Physician
047775
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A527370
MEDI-CAL
CA
Enumeration date
10/03/2006
Last updated
08/10/2009
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