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General NPI Number Information
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NPI Number | 1639731334
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Entity Type | Organization
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Legal Business Name | YALE SURGICAL O&P, LLC
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 305 BOSTON AVE
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City | STRATFORD
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State | CT
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Zip | 06614-5246
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Country | US
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Telephone | 203-338-8485
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Fax |
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Provider Business Mailing Address
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Address Line | 627 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-6992
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Country | US
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Telephone | 203-777-2396
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Fax |
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Authorized Official
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Title or Position | CPO
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Name | EDWARD NICHOLAS KAUFMAN
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Credential |
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Telephone | 203-996-3878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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