Healthcare Provider Details
I. General information
NPI: 1437313657
Provider Name (Legal Business Name): IRIS G STREIMISH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/16/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
YALE NEW HAVEN HOSPITAL 20 YORK STREET, PEDIATRICS, PERINATAL MEDICINE WP493
NEW HAVEN CT
06510
US
IV. Provider business mailing address
16 HARCOURT ST APARTMENT 16
BOSTON MA
02116-6427
US
V. Phone/Fax
- Phone: 203-688-2318
- Fax:
- Phone: 203-688-2318
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 236472 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: