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General NPI Number Information
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NPI Number | 1043572910
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Entity Type | Organization
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Legal Business Name | YNHH-COMMUNITY ONCOLOGY PRACTICE
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 200 KENNEDY DR
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City | TORRINGTON
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State | CT
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Zip | 06790-3096
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Country | US
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Telephone | 203-688-2603
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Fax |
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Provider Business Mailing Address
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Address Line | 20 YORK ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR VP OF FINANCE
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Name | MR. JAMES STATEN
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Credential |
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Telephone | 203-688-2603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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