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General NPI Number Information
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NPI Number | 1255340634
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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 | 08/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location 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 | 203-688-2318
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Fax |
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Provider Business Mailing Address
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Address Line | 10 LAKEVIEW AVE APT #2
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City | SHELTON
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State | CT
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Zip | 06484-2312
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Country | US
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Telephone | 203-926-9399
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Fax |
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Authorized Official
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Title or Position | PA-C IN NBSCU
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Name | MS. JULIE MARISSA QUARTUCCIO
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Credential | PA-C
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Telephone | 203-688-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281PC2000X
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Taxonomy Name | Children's Chronic Disease Hospital
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License Number | 001537
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License Number State | CT
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