Provider Demographics
NPI:1013987700
Name:GASSMAN, VITTORIA (MD)
Entity Type:Individual
Prefix:
First Name:VITTORIA
Middle Name:
Last Name:GASSMAN
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 1:120 CONNECTICUT AVE
Mailing Address - Street 2:NORWALK COMMUNITY HEALTH CENTER
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-1525
Mailing Address - Country:US
Mailing Address - Phone:203-899-1770
Mailing Address - Fax:
Practice Address - Street 1:120 CONNECTICUT AVE
Practice Address - Street 2:NORWALK COMMUNITY HEALTH CENTER
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-1525
Practice Address - Country:US
Practice Address - Phone:203-899-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034764207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP1904083OtherOXFORD
CT001347641Medicaid
CT2052972OtherUHC
CT61522078OtherAETNA
CT2V2429OtherHEALTHNET
CT3731399OtherCIGNA
CT010034764CT02OtherANTHEM B/C
CT2052972OtherUHC
110007753Medicare ID - Type UnspecifiedMEDICARE