Doctor Name: | STEFAN MANSOURIAN |
NPI Number: | 1063694081 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 54766 |
Business Practice Address: | 950 Campbell Ave Department Of Radiology West Haven, CT - 065162770 |
Business Phone Number: | 2039325711 |
Business Fax Number: | |
Mailing Address: | 950 Campbell Ave, Department Of Radiology WEST HAVEN |
State: | CT |
Postal Code: | 065162770 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/30/2007 |
NPI Last Update Date: | 11/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 54766 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |