Healthcare Provider Details

I. General information

NPI: 1063082923
Provider Name (Legal Business Name): DI YI HE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

764 CAMPBELL AVE
WEST HAVEN CT
06516-3786
US

IV. Provider business mailing address

764 CAMPBELL AVE STE E
WEST HAVEN CT
06516-3786
US

V. Phone/Fax

Practice location:
  • Phone: 203-931-0034
  • Fax: 203-931-8225
Mailing address:
  • Phone: 203-931-0034
  • Fax: 203-931-8225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.009914
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: