Provider Demographics
NPI:1053574533
Name:PIETRAS, COLLEEN MARY (MD)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:MARY
Last Name:PIETRAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:330 CEDAR STREET, BOARDMAN 204
Mailing Address - Street 2:P.O. BOX 208041
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510
Mailing Address - Country:US
Mailing Address - Phone:203-785-5000
Mailing Address - Fax:203-785-3346
Practice Address - Street 1:330 CEDAR STREET
Practice Address - Street 2:BOARDMAN 204
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-785-5000
Practice Address - Fax:203-785-3346
Is Sole Proprietor?:No
Enumeration Date:2008-07-06
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT619412208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)