Organization
YALE-NEW HAVEN HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD D'AQUILLA (PRESIDENT)
(203) 688-2606
Entity
Organization
Contact information
Practice address
789 HOWARD AVE, DANA 2, NEW HAVEN, CT 06519-1304
(203) 688-2464
(203) 688-1426
Mailing address
20 YORK STREET - DENTAL, NEW HAVEN, CT 06510-3020
(203) 688-1288
(203) 688-4461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0044
CT
1223P0106X
Oral and Maxillofacial Pathology Dentistry
0044
CT
261QD0000X
Dental Clinic/Center
0044
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004011318
—
CT
Enumeration date
04/03/2015
Last updated
05/19/2016
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