Organization Name: | MARGARET CHUSTECKA INTERNAL MEDICINE OF GREATER NEW HAVEN |
NPI Number: | 1053344473 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DORIS NODELMAN (OFFICE MANAGER) |
Mailing Address: | 1952 Whitney Ave Hamden |
State: | CT US |
Postal Code: | 06517 |
Phone Number: | 2038481803 |
Fax Number: | 2038481777 |
NPI Enumeration Date: | 07/09/2006 |
NPI Last Update Date: | 01/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |