Healthcare Provider Details

I. General information

NPI: 1700035292
Provider Name (Legal Business Name): YALE UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST YALE NEW HAVEN HOSPITAL
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

PO BOX 9805
NEW HAVEN CT
06536-0805
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-7026
  • Fax: 203-737-1077
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIANNE DESS-SANTORO
Title or Position: CHIEF OPERATING OFFICE
Credential:
Phone: 203-785-2140