Individual
ANDRE GHANTOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-4290
(203) 789-6046
Mailing address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-6044
(203) 789-6046
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
035612
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001356121
—
CT
Enumeration date
05/25/2006
Last updated
11/19/2013
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