Healthcare Provider Details

I. General information

NPI: 1649441841
Provider Name (Legal Business Name): REBECCA F CHERON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST YALE NEW HAVEN HOSPITAL- WEST PAVILION 2ND FLOOR
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

PO BOX 208064 333 CEDAR ST
NEW HAVEN CT
06520-8064
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-4081
  • Fax: 203-785-3833
Mailing address:
  • Phone: 203-737-1697
  • Fax: 203-737-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number003726
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: