Provider First Line Business Practice Location Address:
DEPT OF PSYCHIATRY,116A
Provider Second Line Business Practice Location Address:
VA CONNECTICUT HEALTHCARE SYSTEM
Provider Business Practice Location Address City Name:
WEST HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-932-5711
Provider Business Practice Location Address Fax Number:
775-599-1511
Provider Enumeration Date:
09/22/2006