Healthcare Provider Details

I. General information

NPI: 1366403164
Provider Name (Legal Business Name): MICHAEL RECHT MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/13/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CEDAR ST
NEW HAVEN CT
06510-3206
US

IV. Provider business mailing address

333 CEDAR ST
NEW HAVEN CT
06510-3206
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-4640
  • Fax:
Mailing address:
  • Phone: 203-785-4640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number26468
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: