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General NPI Number Information
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NPI Number | 1255229290
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Entity Type | Organization
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Legal Business Name | YALE NEW HAVEN HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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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 | 33 OLD TAVERN RD APT 129
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City | ORANGE
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State | CT
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Zip | 06477-3457
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Country | US
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Telephone | 717-753-2332
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARNA BORGSTROM
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Credential |
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Telephone | 855-547-4584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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