Provider Demographics
NPI:1366769572
Name:BALDASSARRI, REBECCA JOU (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JOU
Last Name:BALDASSARRI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:950 CAMPBELL AVE
Mailing Address - Street 2:BUILDING 1 ROOM 1171
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2770
Mailing Address - Country:US
Mailing Address - Phone:203-932-5711
Mailing Address - Fax:
Practice Address - Street 1:950 CAMPBELL AVE
Practice Address - Street 2:BUILDING 1 ROOM 1171
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2770
Practice Address - Country:US
Practice Address - Phone:203-932-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT54037207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology