MEDICARE: DR. JOSEPH A. MADRI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator	02281	CT
2	282N00000X	General Acute Care Hospital	022381	CT

General Provider Information

NPI Number	:	1225403801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH A. MADRI M.D.

Provider Business Mailing Address
First Line	:	310 CEDAR STREET
Second Line	:	YALE UNIV. YALE NEW HAVEN HOSPITAL
City	:	NEW HAVEN
State	:	CT
Zip	:	06520-8023
Country	:	US
Telephone Number	:	203-785-2763
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 CEDAR STREET
Second Line	:	YALE UNIV. YALE NEW HAVEN HOSPITAL
City	:	NEW HAVEN
State	:	CT
Zip	:	06520-8023
Country	:	US
Telephone Number	:	203-785-2763
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2015
Last Update Date	:	12/08/2015

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