Provider Demographics
NPI:1538276134
Name:ABREU-LANFRANCO, ODALIZ (MD)
Entity type:Individual
Prefix:DR
First Name:ODALIZ
Middle Name:
Last Name:ABREU-LANFRANCO
Suffix:
Gender:M
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:SAINT RAPHAEL FACULTY PHYSICIANS
Mailing Address - Street 2:PO BOX 18263
Mailing Address - City:BRIDEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06601-3263
Mailing Address - Country:US
Mailing Address - Phone:508-595-0531
Mailing Address - Fax:508-829-5367
Practice Address - Street 1:SAINT RAPHAEL FACULTY PHYSICIANS
Practice Address - Street 2:1450 CHAPEL STREET
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-789-4074
Practice Address - Fax:203-867-5534
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044596207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine