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General NPI Number Information
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NPI Number | 1437490349
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Entity Type | Organization
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Legal Business Name | EAST SHORE DISTRICT HEALTH DEPARTMENT
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 688 E MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-2971
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Country | US
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Telephone | 203-481-4233
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Fax | 203-483-6894
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Provider Business Mailing Address
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Address Line | 688 E MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-2971
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Country | US
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Telephone | 203-481-4233
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Fax | 203-483-6894
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RICHARD YOUNG
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Credential | MD
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Telephone | 203-675-4055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 028111
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License Number State | CT
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