Healthcare Provider Details

I. General information

NPI: 1558939041
Provider Name (Legal Business Name): ALEXANDER ARTCHARIYAVIVIT SVORONOS MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 TEMPLE ST
NEW HAVEN CT
06510-2715
US

IV. Provider business mailing address

40 TEMPLE ST STE 1B
NEW HAVEN CT
06510-2715
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2020
  • Fax:
Mailing address:
  • Phone: 203-785-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number85358
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: