Healthcare Provider Details

I. General information

NPI: 1437842481
Provider Name (Legal Business Name): CITY OF MILFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 NEW HAVEN AVE.
MILFORD CT
06460-4827
US

IV. Provider business mailing address

82 NEW HAVEN AVE.
MILFORD CT
06460-4827
US

V. Phone/Fax

Practice location:
  • Phone: 203-783-3285
  • Fax: 203-783-3286
Mailing address:
  • Phone: 203-783-3285
  • Fax: 203-783-3286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. DEEPA D JOSEPH
Title or Position: DIRECTOR OF HEALTH
Credential: MPH
Phone: 203-783-3285