Basic Information
Provider Information
NPI: 1386730042
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUNDUZ-BRUCE
FirstName: HANDAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: VHA CONNECTICUT, 116-A
Address2: PSYCHIATRY SERVICE
City: WEST HAVEN
State: CT
PostalCode: 06516
CountryCode: US
TelephoneNumber: 2039325711
FaxNumber: 2039374860
Practice Location
Address1: VHA CONNECTICUT, 116-A
Address2: PSYCHIATRY SERVICE
City: WEST HAVEN
State: CT
PostalCode: 06516
CountryCode: US
TelephoneNumber: 2039325711
FaxNumber: 2039374860
Other Information
ProviderEnumerationDate: 10/04/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X036893CTY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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