Organization
FAMILY PRACTICE OF GREATER NEW HAVEN, LLC
Active
Organization
FAMILY PRACTICE OF GREATER NEW HAVEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANATOLY BRAYLOVSKY M.D. (PHYSICIAN/ OWNER)
(203) 269-4200
Entity
Organization
Contact information
Practice address
850 N MAIN STREET EXT, BUILDING 2 SUITE 1B, WALLINGFORD, CT 06492-2400
(203) 269-4200
(203) 269-8800
Mailing address
850 N MAIN STREET EXT, BUILDING 2 SUITE 1B, WALLINGFORD, CT 06492-2400
(203) 269-4200
(203) 269-8800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040951
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001409516
—
CT
Enumeration date
08/21/2006
Last updated
12/20/2007
Update your record
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