Healthcare Provider Details

I. General information

NPI: 1922072057
Provider Name (Legal Business Name): CORNELL SCOTT HILL HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 COLUMBUS AVE PEDIATRICS
NEW HAVEN CT
06519-1233
US

IV. Provider business mailing address

400 COLUMBUS AVE
NEW HAVEN CT
06519-1233
US

V. Phone/Fax

Practice location:
  • Phone: 203-503-3000
  • Fax: 203-503-3224
Mailing address:
  • Phone: 203-503-3000
  • Fax: 203-503-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MEREDITH H WILLIAMS
Title or Position: DIRECTOR OF PEDIARICS
Credential: MD
Phone: 203-503-3403