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Organization

SOUTHERN CONNECTICUT GERIATRIC & PREVENTIVE MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ASEFEH HEIAT M.D., M.P.H. (MEMBER)
(203) 871-9224
Entity
Organization

Contact information

Practice address
390 LIVINGSTON ST, NEW HAVEN, CT 06511-1336
(203) 871-9224
Mailing address
390 LIVINGSTON ST, NEW HAVEN, CT 06511-1336
(203) 871-9224

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
041288
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
2083P0901X
Public Health & General Preventive Medicine Physician
041288
CT

Other

Enumeration date
06/25/2009
Last updated
10/04/2021
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