Healthcare Provider Details

I. General information

NPI: 1043217482
Provider Name (Legal Business Name): YALE NEW HAVEN HEALTH AT HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LONG WHARF DRIVE SUITE 501
NEW HAVEN CT
06511
US

IV. Provider business mailing address

1 LONG WHARF DRIVE SUITE 501
NEW HAVEN CT
06511
US

V. Phone/Fax

Practice location:
  • Phone: 203-777-5521
  • Fax: 203-859-6757
Mailing address:
  • Phone: 203-777-5521
  • Fax: 203-859-6757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberC8024
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberC8024
License Number StateCT

VIII. Authorized Official

Name: CYNTHIA GIBBONS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 475-254-2177