Healthcare Provider Details

I. General information

NPI: 1538523774
Provider Name (Legal Business Name): KATYAYANI PAPATLA MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PARK ST
NEW HAVEN CT
06519-1110
US

IV. Provider business mailing address

35 PARK ST
NEW HAVEN CT
06519-1110
US

V. Phone/Fax

Practice location:
  • Phone: 203-200-4176
  • Fax: 203-200-2560
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number75119
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: