Organization
NEW HAVEN PUBLIC SCHOOLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS CEBALLOS PA, M.P.H. (DIRECTOR)
(203) 234-9317
Entity
Organization
Contact information
Practice address
54 MEADOW ST, NEW HAVEN, CT 06519-1783
(203) 946-8969
(203) 946-8664
Mailing address
54 MEADOW ST, NEW HAVEN, CT 06519-1783
(203) 946-8969
(203) 946-8664
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
PENDING
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0V1232
HEALTH NET PROVIDER ID
CT
01
—
166185
VALUE OPTIONS PROVIDER NO
CT
Enumeration date
03/29/2007
Last updated
07/13/2007
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