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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

Other

Enumeration date
06/19/2009
Last updated
11/03/2015
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