Provider First Line Business Practice Location Address:
20 YORK STREET
Provider Second Line Business Practice Location Address:
YALE NEW HAVEN HOSPITAL-CB 407
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06519-1369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-688-3475
Provider Business Practice Location Address Fax Number:
203-688-8177
Provider Enumeration Date:
11/03/2005