Healthcare Provider Details

I. General information

NPI: 1124215744
Provider Name (Legal Business Name): CHRISTOPHER J CUTTER JR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 08/24/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 SOUTH FRONTAGE ST. YALE CHILD STUDY CENTER
NEW HAVEN CT
06519-7900
US

IV. Provider business mailing address

PO BOX 207900
NEW HAVEN CT
06520-7900
US

V. Phone/Fax

Practice location:
  • Phone: 203-737-1352
  • Fax: 203-737-2797
Mailing address:
  • Phone: 203-737-2135
  • Fax: 203-737-2797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number003384
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: