Basic Information
Provider Information
NPI: 1720099864
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUJIC
FirstName: DENISA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1423 CHAPEL ST
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 06511
CountryCode: US
TelephoneNumber: 2038653852
FaxNumber: 2038652983
Practice Location
Address1: 1450 CHAPEL ST
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 06511
CountryCode: US
TelephoneNumber: 2037893538
FaxNumber: 2038675461
Other Information
ProviderEnumerationDate: 08/11/2006
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
207L00000XCT037430CTY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home