Organization
VALLEY VASCULAR ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUNG K SHIN M.D. (MANAGING OFFICER)
(203) 855-9806
Entity
Organization
Contact information
Practice address
91 EAST AVE, NORWALK, CT 06851-5020
(203) 855-9806
(203) 855-1135
Mailing address
91 EAST AVE, NORWALK, CT 06851-5020
(203) 855-9806
(203) 855-1135
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
037720
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001377200
—
CT
01
—
010037720CT02
ANTHEM - DERBY
CT
01
—
010037720CT03
ANTHEM -NORWALK
CT
01
—
010037720CT04
ANTHEM - BPT
CT
01
—
037720
CONNECTICARE
CT
01
—
178311
WELLCARE
CT
01
—
2322912
AETNA/US HEALTHCARE
CT
01
—
3324246-004
CIGNA
CT
01
—
770002444
MEDICARE RAILROAD
CT
01
—
P2061278
OXFORD
CT
Enumeration date
10/04/2012
Last updated
10/04/2012
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