Provider First Line Business Practice Location Address:
20 YORK ST
Provider Second Line Business Practice Location Address:
YPH LV-111
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06504-8900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-688-9867
Provider Business Practice Location Address Fax Number:
203-688-3596
Provider Enumeration Date:
05/24/2006