Provider Demographics
NPI:1205833167
Name:PUN, MANUEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:C
Last Name:PUN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:112 QUARRY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4816
Mailing Address - Country:US
Mailing Address - Phone:203-333-8800
Mailing Address - Fax:203-333-6054
Practice Address - Street 1:112 QUARRY RD
Practice Address - Street 2:SUITE 400
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4816
Practice Address - Country:US
Practice Address - Phone:203-333-8800
Practice Address - Fax:203-333-6054
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2014-11-14
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Provider Licenses
StateLicense IDTaxonomies
CT027184207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400133737Medicare PIN
CT110004862Medicare ID - Type Unspecified
CTB38637Medicare UPIN