Individual
DR. MARK GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
789 HOWARD AVE, NEW HAVEN, CT 06519-1304
(203) 785-4198
Mailing address
789 HOWARD AVE, NEW HAVEN, CT 06519-1304
(203) 785-4198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP02748
RI
207R00000X
Internal Medicine Physician
MD15361
RI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
65880
CT
207RP1001X
Pulmonary Disease Physician
Primary
65880
CT
Other
Enumeration date
05/28/2013
Last updated
07/21/2022
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