Provider Demographics
NPI:1245261098
Name:ASIS, MARIA C (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:ASIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:C
Other - Last Name:GILBRIDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2446 WHITNEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-248-4461
Mailing Address - Fax:203-248-3932
Practice Address - Street 1:2446 WHITNEY AVENUE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-248-4461
Practice Address - Fax:203-248-3932
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033137207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F62889Medicare UPIN
160001172Medicare ID - Type Unspecified