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General NPI Number Information
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NPI Number | 1871796383
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Entity Type | Organization
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Legal Business Name | YALE UNIV SCHOOL OF MEDICINE
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 230 SOUTH FRONTAGE ROAD
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City | NEW HAVEN
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State | CT
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Zip | 06519-0309
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Country | US
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Telephone | 203-785-4216
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Fax |
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Provider Business Mailing Address
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Address Line | 230 SOUTH FRONTAGE ROAD
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City | NEW HAVEN
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State | CT
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Zip | 06519-0309
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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 | VICE CHAIRMAN FOR CLINICAL AFFAIRS
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Name | JOSEPH WOOLSTEN
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Credential | M.D.
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Telephone | 203-785-4216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | CT
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