Healthcare Provider Details
I. General information
NPI: 1730195918
Provider Name (Legal Business Name): PHILIP JOHN NOTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1450 CHAPEL ST
NEW HAVEN CT
06511
US
IV. Provider business mailing address
1423 CHAPEL ST
NEW HAVEN CT
06511
US
V. Phone/Fax
- Phone: 203-789-3508
- Fax: 203-867-5461
- Phone: 203-865-3852
- Fax: 203-865-2983
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | CT015472 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 015472 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: