MEDICARE: JEFFREY R GRUEN MD

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	2080N0001X	Neonatal-Perinatal Medicine Physician	025237	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598748709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY R GRUEN MD

Provider Business Mailing Address
First Line	:	PO BOX 9805
Second Line	:	300 GEORGE ST 6TH FLOOR
City	:	NEW HAVEN
State	:	CT
Zip	:	06536-0805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 YORK ST
Second Line	:	YNHH (CHILDREN'S) WEST PAVILION - 2ND FLOOR
City	:	NEW HAVEN
State	:	CT
Zip	:	06504-8900
Country	:	US
Telephone Number	:	203-688-2320
Fax Number	:	203-688-5426

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/07/2008

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Directions to “ JEFFREY R GRUEN MD” Practice Location

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