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Organization
SOUTHERN NEW ENGLAND EAR, NOSE, THROAT AND FACIAL PLASTIC SURGERY GROU
Active
Organization
SOUTHERN NEW ENGLAND EAR, NOSE, THROAT AND FACIAL PLASTIC SURGERY GROU
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EIIZABETH IRENE SULLIVAN (CEO)
(203) 777-7500
Entity
Organization
Contact information
Practice address
ONE LONG WHARF DRIVE, SUITE #302, NEW HAVEN, CT 06511-5593
(203) 777-7500
(203) 777-8469
Mailing address
ONE LONG WHARF DRIVE, SUITE #302, NEW HAVEN, CT 06511-5593
(203) 777-7500
(203) 777-8469
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
034314
CT
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
NULL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/19/2009
Last updated
11/03/2015
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