Healthcare Provider Details

I. General information

NPI: 1285825232
Provider Name (Legal Business Name): TERRI LYNN PARKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST YALE-NEW HAVEN HOSPITAL
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

117 WOOSTER ST APT 1
NEW HAVEN CT
06511-5721
US

V. Phone/Fax

Practice location:
  • Phone: 203-200-4363
  • Fax: 203-785-4116
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number46863
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number046863
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: