Provider Demographics
NPI:1588975429
Name:KURUVILLA, DEENA (MD)
Entity type:Individual
Prefix:DR
First Name:DEENA
Middle Name:
Last Name:KURUVILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TURKEY HILL RD S STE 201
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5525
Mailing Address - Country:US
Mailing Address - Phone:203-391-6105
Mailing Address - Fax:
Practice Address - Street 1:1 TURKEY HILL RD S STE 201
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5525
Practice Address - Country:US
Practice Address - Phone:203-391-6105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT531832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology