Healthcare Provider Details

I. General information

NPI: 1720314164
Provider Name (Legal Business Name): YONATHAN FUCHS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOWARD AVE
NEW HAVEN CT
06519-1369
US

IV. Provider business mailing address

800 HOWARD AVE
NEW HAVEN CT
06519-1369
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-4649
  • Fax:
Mailing address:
  • Phone: 203-785-4649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number244232
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberME118942
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2080T0004X
TaxonomyPediatric Transplant Hepatology Physician
License Number68688
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: