Provider Demographics
NPI:1114416757
Name:NAKA, FLUDIONA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:FLUDIONA
Middle Name:
Last Name:NAKA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 FARMINGTON AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1979
Mailing Address - Country:US
Mailing Address - Phone:860-676-7000
Mailing Address - Fax:
Practice Address - Street 1:399 FARMINGTON AVE STE 260
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1979
Practice Address - Country:US
Practice Address - Phone:860-676-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT71442207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology