Individual
MICHELLE ANNE VAN NAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LONG WHARF DR, SUITE 503, NEW HAVEN, CT 06511-5991
(203) 785-5809
Mailing address
1 LONG WHARF DR, SUITE 503, NEW HAVEN, CT 06511-5991
(203) 785-5809
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
50005
CT
Other
Enumeration date
05/05/2008
Last updated
06/22/2015
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