MEDICARE: CITY OF NEW HAVEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	0220	CT

General Provider Information

NPI Number	:	1790879971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF NEW HAVEN

Provider Business Mailing Address
First Line	:	54 MEADOW ST
Second Line	:	9TH FLOOR
City	:	NEW HAVEN
State	:	CT
Zip	:	06519-1783
Country	:	US
Telephone Number	:	203-946-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 MEADOW ST
Second Line	:	9TH FLOOR
City	:	NEW HAVEN
State	:	CT
Zip	:	06519-1783
Country	:	US
Telephone Number	:	203-946-6999
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF HEALTH
Name	:	MR. WILLIAM QUINN
Credential	:	MPH
Telephone Number	:	203-946-6999

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/22/2020

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Directions to “CITY OF NEW HAVEN ” Practice Location

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