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339 Eastern St New Haven CT 06513-2463 | |
| (203) 777-7411 | |
| (203) 777-8506 |
| Full Name | |
|---|---|
| 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 |
|---|---|
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 |
|---|---|
| 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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