Healthcare Provider Details

I. General information

NPI: 1790879971
Provider Name (Legal Business Name): CITY OF NEW HAVEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 MEADOW ST 9TH FLOOR
NEW HAVEN CT
06519-1783
US

IV. Provider business mailing address

54 MEADOW ST 9TH FLOOR
NEW HAVEN CT
06519-1783
US

V. Phone/Fax

Practice location:
  • Phone: 203-946-6999
  • Fax:
Mailing address:
  • Phone: 203-946-6999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0220
License Number StateCT

VIII. Authorized Official

Name: MR. WILLIAM QUINN
Title or Position: DIRECTOR OF HEALTH
Credential: MPH
Phone: 203-946-6999