Provider Demographics
NPI:1396902342
Name:YALE UNIVERSITY
Entity type:Organization
Organization Name:YALE UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER, CLAIMS AND BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-432-1003
Mailing Address - Street 1:55 LOCK ST
Mailing Address - Street 2:PO BOX 208237
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3603
Mailing Address - Country:US
Mailing Address - Phone:203-432-0076
Mailing Address - Fax:203-432-7289
Practice Address - Street 1:55 LOCK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3603
Practice Address - Country:US
Practice Address - Phone:203-432-0076
Practice Address - Fax:203-432-7289
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YALE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-19
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0005261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1093862740OtherINSTITUTIONAL NPI
CT1093862740OtherINSTITUTIONAL NPI