Individual
JOHN M LEVENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
789 HOWARD AVE, YNHH BASEMENT, NEW HAVEN, CT 06519-1304
(203) 688-2468
(203) 688-7274
Mailing address
PO BOX 9805, 300 GEORGE ST, 6TH FLOOR, NEW HAVEN, CT 06536-0805
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
020734
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001207349
—
CT
Enumeration date
11/25/2005
Last updated
02/13/2009
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