Individual
WAYNE PANULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 TEMPLE ST, SUITE 4A, NEW HAVEN, CT 06510-2715
(203) 777-0304
(203) 401-4687
Mailing address
40 TEMPLE ST, SUITE 4A, NEW HAVEN, CT 06510-2715
(203) 777-0304
(203) 401-4687
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
027342
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001273424
—
CT
Enumeration date
02/14/2007
Last updated
02/13/2012
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