Provider Demographics
NPI:1700999869
Name:VINING, EUGENIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIA
Middle Name:M
Last Name:VINING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:31 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-2304
Mailing Address - Country:US
Mailing Address - Phone:203-234-1324
Mailing Address - Fax:203-239-3047
Practice Address - Street 1:46 PRINCE ST
Practice Address - Street 2:SUITE 601
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1600
Practice Address - Country:US
Practice Address - Phone:203-752-1726
Practice Address - Fax:203-752-1838
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT033134207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F42429Medicare UPIN