Healthcare Provider Details

I. General information

NPI: 1336124676
Provider Name (Legal Business Name): YUENCHENG HAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 STRAITS TPKE
MIDDLEBURY CT
06762-2833
US

IV. Provider business mailing address

7 REGENT CT
CHESHIRE CT
06410-1928
US

V. Phone/Fax

Practice location:
  • Phone: 203-758-2300
  • Fax: 203-624-4465
Mailing address:
  • Phone: 203-272-2723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number039392
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number039392
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: