Provider Demographics
NPI:1427045699
Name:WURZEL, RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:WURZEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST STE 416
Mailing Address - Street 2:HARTFORD HEALTHCARE MEDICAL GROUP
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5523
Mailing Address - Country:US
Mailing Address - Phone:860-947-8500
Mailing Address - Fax:860-524-8643
Practice Address - Street 1:85 SEYMOUR ST STE 416
Practice Address - Street 2:HARTFORD HEALTHCARE MEDICAL GROUP
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5523
Practice Address - Country:US
Practice Address - Phone:860-947-8500
Practice Address - Fax:860-524-8643
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT023487208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1255448155OtherGHMC GROUP NPI ID
CT482013OtherAETNA
CT004214467Medicaid
CT010023487CT06OtherBCBS & BCFP
CT001234871Medicaid
CT01223487OtherCIGNA
CT134852OtherWELLCARE MEDICARE
CT060069OtherHEALTH NET
CT07608703OtherCONNECTICARE
CTP369846OtherOXFORD
CT010023487CT06OtherBCBS & BCFP
CT07608703OtherCONNECTICARE
CT482013OtherAETNA