Organization
SAINT RAPHAEL FACULTY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE MCMANUS (CHIEF FINANCIAL OFFICER)
(203) 789-4059
Entity
Organization
Contact information
Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-5946
(203) 867-5287
Mailing address
PO BOX 1951, BRATTLEBORO, VT 05302-1951
(508) 595-0531
(508) 829-5367
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008002212
—
CT
05
—
008002476
—
CT
05
—
008002615
—
CT
05
—
008002619
—
CT
05
—
008003155
—
CT
Enumeration date
07/01/2006
Last updated
04/19/2013
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