Organization
WEST HAVEN MEDICAL GROUP, LLC
Active
Organization
WEST HAVEN MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANURUDDHA WALALIYADDA M.D. (MANAGING PARTNER)
(203) 932-6481
Entity
Organization
Contact information
Practice address
687 CAMPBELL AVE, WEST HAVEN, CT 06516-3774
(203) 932-6481
(203) 932-4051
Mailing address
687 CAMPBELL AVE, WEST HAVEN, CT 06516-3774
(203) 932-6481
(203) 932-4051
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
016797
CT
207R00000X
Internal Medicine Physician
Primary
016636
CT
Other
Enumeration date
07/08/2005
Last updated
01/21/2014
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