Provider First Line Business Practice Location Address:
230 S FRONTAGE RD
Provider Second Line Business Practice Location Address:
CHILD STUDY CENTER - SHM I-207
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06519-1124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-785-2513
Provider Business Practice Location Address Fax Number:
203-785-4914
Provider Enumeration Date:
10/26/2005