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General NPI Number Information
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NPI Number | 1073947065
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Entity Type | Organization
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Legal Business Name | YALE NEW HAVEN HOSPITAL
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Dates
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Enumeration Date | 08/26/2013
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Last Update Date | 08/26/2013
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Provider Practice Location Address
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Address Line | 1450 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4405
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Country | US
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Telephone | 203-789-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 809 RACEBROOK RD
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City | ORANGE
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State | CT
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Zip | 06477-1232
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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 | PSYCHIATRIC SOCIAL WORKER
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Name | MRS. JERILYN B CELENTANO
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Credential | LCSW
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Telephone | 203-789-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 008236
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License Number State | CT
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