Healthcare Provider Details

I. General information

NPI: 1447204805
Provider Name (Legal Business Name): JEAN-FRANCOIS H GESCHWIND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST RADIOLOGY AND BIOMEDICAL IMAGING
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

PO BOX 208042 RADIOLOGY AND BIOMEDICAL IMAGING
NEW HAVEN CT
06520-8042
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-5865
  • Fax:
Mailing address:
  • Phone: 203-785-5865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number054802
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number054802
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: