Healthcare Provider Details

I. General information

NPI: 1679545693
Provider Name (Legal Business Name): CHILD AND ADOLESCENT HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 WHITNEY AVE
NEW HAVEN CT
06511-7204
US

IV. Provider business mailing address

303 WHITNEY AVE
NEW HAVEN CT
06511-7204
US

V. Phone/Fax

Practice location:
  • Phone: 203-776-1243
  • Fax: 203-785-1247
Mailing address:
  • Phone: 203-776-1243
  • Fax: 203-785-1247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM JOSEPH AUNI SINGER
Title or Position: PARTNER
Credential: MD
Phone: 203-776-1243