Healthcare Provider Details

I. General information

NPI: 1841280385
Provider Name (Legal Business Name): MEENA SAVUR MORAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOWARD AVE YALE PHYSICIANS BLDG
NEW HAVEN CT
06519-1369
US

IV. Provider business mailing address

PO BOX 9805 300 GEORGE ST 6TH FLOOR
NEW HAVEN CT
06536-0805
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-6384
  • Fax: 203-785-4622
Mailing address:
  • Phone: 203-785-6610
  • Fax: 203-785-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number036898
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: