Provider Demographics
NPI:1538452594
Name:WURZEL, LOIS (MD)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:WURZEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BAYBERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-2800
Mailing Address - Country:US
Mailing Address - Phone:860-676-1981
Mailing Address - Fax:860-678-8895
Practice Address - Street 1:77 BAYBERRY HILL RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-2800
Practice Address - Country:US
Practice Address - Phone:860-558-6527
Practice Address - Fax:860-678-8895
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT025894207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology