Individual
ANDREW T. PICKENS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
YALE MEDICAL SCHOOL, 333 CEDAR ST., NEW HAVEN, CT 06511
(203) 789-3464
Mailing address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-3464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2008-00003
NC
207P00000X
Emergency Medicine Physician
320799
NY
207P00000X
Emergency Medicine Physician
Primary
61664
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909865
—
NC
Enumeration date
05/02/2007
Last updated
04/28/2025
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