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Individual

BRUCE P WAINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1825 BARNUM AVE, SUITE 203, STRATFORD, CT 06614-5333
(203) 377-5493
(203) 380-0874
Mailing address
1825 BARNUM AVE, SUITE 203, STRATFORD, CT 06614-5333
(203) 377-5493
(203) 380-0874

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
025902
CT
208000000X
Pediatrics Physician
025902
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1259027
CT
Enumeration date
09/08/2006
Last updated
10/24/2008
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