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Organization

JOHN M WILLETT MD

Active
Parent organization
JOHN M WILLETT MD
Organization subpart
Yes

Provider details

NPI number
Legal business name
JOHN M WILLETT MD
Authorized official
MRS. ELIZABETH SULLIVAN (PRACTICE MANGER)
(230) 777-7500
Entity
Organization

Contact information

Practice address
1 LONG WHARF DRIVE, SUITE 302, NEW HAVEN, CT 06511
(203) 777-7500
(203) 777-8469
Mailing address
1 LONG WHARF DRIVE, SUITE 302, NEW HAVEN, CT 06511
(203) 777-7500
(203) 777-8469

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001317363
CT
Enumeration date
01/23/2023
Last updated
01/23/2023
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