Provider Demographics
NPI:1558425678
Name:VASILE, JULIE VANILLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:VANILLE
Last Name:VASILE
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 1:1290 SUMMER ST
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5360
Mailing Address - Country:US
Mailing Address - Phone:203-965-0656
Mailing Address - Fax:203-965-0646
Practice Address - Street 1:1290 SUMMER ST
Practice Address - Street 2:SUITE 3200
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5360
Practice Address - Country:US
Practice Address - Phone:203-965-0656
Practice Address - Fax:203-965-0646
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220384174400000X
CT046797208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery