Healthcare Provider Details

I. General information

NPI: 1063696557
Provider Name (Legal Business Name): CHRISTOPHER THOMAS WHITLOW M.D./PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CEDAR ST
NEW HAVEN CT
06510-3206
US

IV. Provider business mailing address

20 YORK ST
NEW HAVEN CT
06510-3220
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-6938
  • Fax:
Mailing address:
  • Phone: 336-716-6255
  • Fax: 336-716-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number83092
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: