Provider Demographics
NPI:1477059509
Name:MARSEILLE, URIELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:URIELLE
Middle Name:
Last Name:MARSEILLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 HAWLEY LN FL 3
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1202
Mailing Address - Country:US
Mailing Address - Phone:203-502-4650
Mailing Address - Fax:475-246-9894
Practice Address - Street 1:196 PARKWAY S
Practice Address - Street 2:SUITE 103
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385
Practice Address - Country:US
Practice Address - Phone:860-437-6764
Practice Address - Fax:860-865-2392
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT68065207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT68065OtherLICENSE
CT1477059509Medicaid