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General NPI Number Information
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NPI Number | 1073900486
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Entity Type | Individual
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Provider Name | CHRISTOPHER ANDERSON
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Gender | Male
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 01/22/2018
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Provider Practice Location Address
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Address Line | 441 ORANGE ST STE 6
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City | NEW HAVEN
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State | CT
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Zip | 06511-6217
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Country | US
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Telephone | 203-710-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 96 LYON ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4927
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Country | US
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Telephone | 203-710-8633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8975
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License Number State | CT
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