Healthcare Provider Details

I. General information

NPI: 1548269624
Provider Name (Legal Business Name): HOSPITAL OF SAINT RAPHAEL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 CHAPEL ST
NEW HAVEN CT
06511-4405
US

IV. Provider business mailing address

1450 CHAPEL ST
NEW HAVEN CT
06511-4405
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-3000
  • Fax:
Mailing address:
  • Phone: 203-789-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateCT

VIII. Authorized Official

Name: MRS. ELIZABETH A MARTIN
Title or Position: DIRECTOR, PATIENT ACCOUNTING
Credential:
Phone: 203-789-4241