Provider Demographics
NPI:1528034048
Name:VELLA, ADAM EDWARD (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:EDWARD
Last Name:VELLA
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 1:11 ABBOTTS LN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-2138
Mailing Address - Country:US
Mailing Address - Phone:917-608-6586
Mailing Address - Fax:
Practice Address - Street 1:38 MAPLE ST.
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06856
Practice Address - Country:US
Practice Address - Phone:203-852-2000
Practice Address - Fax:212-426-5083
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT802512080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02444957Medicaid
CT80251OtherCONNECTICUT DEPARTMENT OF HEALTH
NY02590527Medicaid
NY910V01Medicare ID - Type Unspecified