1528453883 NPI number — YALE-NEW HAVEN HOSPITAL

Table of content: (NPI 1528453883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528453883 NPI number — YALE-NEW HAVEN HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YALE-NEW HAVEN HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528453883
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 YORK STREET - DENTAL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06510-3220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-688-1288
Provider Business Mailing Address Fax Number:
203-688-4461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1450 CHAPEL ST
Provider Second Line Business Practice Location Address:
ORAL & MAXILLOFACIAL SURGERY
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06511-4405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-688-1288
Provider Business Practice Location Address Fax Number:
203-688-4461
Provider Enumeration Date:
04/03/2015

Additional Information

Authorized Official

Authorized Official Last Name:
D'AQUILLA
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
203-688-2606

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  0044 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004011318 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com