Individual
RICHARD J ANTAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS BUILDING, NEW HAVEN, CT 06519-1369
(203) 785-2140
Mailing address
PO BOX 9805, 300 GEORGE ST, 6TH FLOOR, NEW HAVEN, CT 06536-0805
(203) 785-7998
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036949
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001369497
—
CT
Enumeration date
11/03/2005
Last updated
07/08/2007
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