Healthcare Provider Details

I. General information

NPI: 1225403801
Provider Name (Legal Business Name): JOSEPH A. MADRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CEDAR STREET YALE UNIV. YALE NEW HAVEN HOSPITAL
NEW HAVEN CT
06520-8023
US

IV. Provider business mailing address

310 CEDAR STREET YALE UNIV. YALE NEW HAVEN HOSPITAL
NEW HAVEN CT
06520-8023
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2763
  • Fax:
Mailing address:
  • Phone: 203-785-2763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number02281
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number022381
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: