Healthcare Provider Details

I. General information

NPI: 1154668622
Provider Name (Legal Business Name): KAREN M. MOYER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PARK ST CONNECTICUT MENTAL HEALTH CENTER
NEW HAVEN CT
06519-1109
US

IV. Provider business mailing address

34 PARK ST CONNECTICUT MENTAL HEALTH CENTER
NEW HAVEN CT
06519-1109
US

V. Phone/Fax

Practice location:
  • Phone: 203-974-7131
  • Fax:
Mailing address:
  • Phone: 203-974-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberDO4256
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14772
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDO4256
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number041658
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: