| State Street Health Services | |
|
911 State St State Street Health Services New Haven CT 06511-3926 | |
| (203) 503-3530 | |
| (203) 782-6243 |
| Full Name | State Street Health Services |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 911 State St, New Haven, Connecticut |
| Authorized Official Name and Position | Sol Maria Gonzalez (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2035033174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Street Health Services Po Box 7720 Credentialing Specialist New Haven CT 06519-0720 Ph: (203) 503-3174 | State Street Health Services 911 State St State Street Health Services New Haven CT 06511-3926 Ph: (203) 503-3530 |
| NPI Number | 1427351626 |
|---|---|
| Provider Enumeration Date | 12/09/2010 |
| Last Update Date | 05/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427351626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 0518 (Connecticut) | Primary |
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