| |
339 Eastern St New Haven CT 06513-2463 | |
(203) 777-7411 | |
(203) 777-8506 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 339 Eastern St, New Haven, Connecticut |
Authorized Official Name and Position | Suzanne P Lagarde (CEO) |
Authorized Official Contact | 2037525129 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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374 Grand Ave New Haven CT 06513-3733 Ph: (203) 777-7411 | 339 Eastern St New Haven CT 06513-2463 Ph: (203) 777-7411 |
NPI Number | 1871770768 |
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Provider Enumeration Date | 01/23/2008 |
Last Update Date | 02/11/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871770768 | NPI | - | NPPES |
004235736 | Medicaid | CT |
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