Provider Demographics
NPI:1306996921
Name:YALE-NEW HAVEN HOSPITAL
Entity type:Organization
Organization Name:YALE-NEW HAVEN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-688-2606
Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:DANA II DEPARTMENT OF DENTISTRY YALE-NEW HAVEN HOSPITAL
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:203-688-2465
Mailing Address - Fax:203-688-4461
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:DANA II DEPARTMENT OF DENTISTRY YALE-NEW HAVEN HOSPITAL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2465
Practice Address - Fax:203-688-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008233261QD0000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental