Provider Demographics
NPI:1588233803
Name:VENTURA, YOSELI EDULI (MD)
Entity type:Individual
Prefix:DR
First Name:YOSELI
Middle Name:EDULI
Last Name:VENTURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1300 HALL BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2918
Mailing Address - Country:US
Mailing Address - Phone:860-714-2376
Mailing Address - Fax:
Practice Address - Street 1:58 MAPLE ST STE 2
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4160
Practice Address - Country:US
Practice Address - Phone:203-709-5935
Practice Address - Fax:203-709-5941
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT77597207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program