| Organization Name: | NORTHEAST DISTRICT DEPARTMENT OF HEALTH |
| NPI Number: | 1417255068 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN STARKEY (DIRECTOR OF HEALTH) |
| Mailing Address: | 69 S Main St Unit 4 Brooklyn |
| State: | CT US |
| Postal Code: | 062343829 |
| Phone Number: | 8607747350 |
| Fax Number: | |
| NPI Enumeration Date: | 03/07/2011 |
| NPI Last Update Date: | 03/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | 999DPH407 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |