Healthcare Provider Details

I. General information

NPI: 1093106866
Provider Name (Legal Business Name): YALE HOME CARE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2015
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1783 MERIDEN WATERBURY TPKE
SOUTHINGTON CT
06479-0268
US

IV. Provider business mailing address

102 PEMBROKE RD
HAMDEN CT
06514-2626
US

V. Phone/Fax

Practice location:
  • Phone: 203-404-1010
  • Fax: 860-426-2898
Mailing address:
  • Phone: 203-404-1010
  • Fax: 860-426-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NIRMALA PANWAR
Title or Position: OWNER
Credential: M.D.
Phone: 203-404-1010