Healthcare Provider Details
I. General information
NPI: 1760336325
Provider Name (Legal Business Name): CEPHAS AYELLAKAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/23/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 YORK ST
NEW HAVEN CT
06510-3220
US
IV. Provider business mailing address
51 VICTORIA CT
HAMDEN CT
06514-4500
US
V. Phone/Fax
- Phone: 203-688-4242
- Fax:
- Phone: 475-201-6152
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 171465 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: