Individual
KELLY LYNNE DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-2259
(203) 688-5599
Mailing address
464 CONGRESS AVE, SUITE 260, NEW HAVEN, CT 06519-1361
(203) 737-2489
(203) 785-4580
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
046275
CT
Other
Enumeration date
02/12/2008
Last updated
08/06/2008
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