Doctor Name: | JESSICA LEE ILLUZZI |
NPI Number: | 1164401022 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 040471 |
Business Practice Address: | 789 Howard Ave New Haven, CT - 065191304 |
Business Phone Number: | 2036884101 |
Business Fax Number: | 2036887274 |
Mailing Address: | Po Box 9805, 300 George Street 6th Floor NEW HAVEN |
State: | CT |
Postal Code: | 065360805 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/10/2006 |
NPI Last Update Date: | 07/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 040471 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |