Healthcare Provider Details

I. General information

NPI: 1568895571
Provider Name (Legal Business Name): YALE NEW HAVEN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 CHAPEL ST CHILDREN'S DAY HOSPITAL - PRIVATE ONE
NEW HAVEN CT
06511-4405
US

IV. Provider business mailing address

1450 CHAPEL ST CHILDREN'S DAY HOSPITAL - PRIVATE ONE
NEW HAVEN CT
06511-4405
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-4016
  • Fax: 203-867-5213
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number007618
License Number StateCT

VIII. Authorized Official

Name: LISA GESLER
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 203-789-4016