Healthcare Provider Details

I. General information

NPI: 1275998981
Provider Name (Legal Business Name): YALE-NEW HAVEN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2015
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

20 YORK ST
NEW HAVEN CT
06510-3220
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-9355
  • Fax:
Mailing address:
  • Phone: 203-688-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0044
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0044
License Number StateCT

VIII. Authorized Official

Name: MR. JAMES M STATEN
Title or Position: SR. VP OF FINANCE CFO
Credential:
Phone: 203-688-2603