Provider First Line Business Practice Location Address:
950 CAMPBELL AVE
Provider Second Line Business Practice Location Address:
PSYCHIATRY SVC 116A, 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:
203-937-4860
Provider Enumeration Date:
10/24/2006