Provider First Line Business Practice Location Address:
20 YORK ST # T-209
Provider Second Line Business Practice Location Address:
YALE-NEW HAVEN HOSPITAL
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-688-2259
Provider Business Practice Location Address Fax Number:
203-688-5599
Provider Enumeration Date:
03/09/2010