Provider Demographics
NPI:1174830228
Name:SAINT RAPHAEL HOSPITAL
Entity Type:Organization
Organization Name:SAINT RAPHAEL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-788-9876
Mailing Address - Street 1:32 HIGH ST
Mailing Address - Street 2:APT # 503
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2314
Mailing Address - Country:US
Mailing Address - Phone:507-271-5974
Mailing Address - Fax:
Practice Address - Street 1:1450, CHAPEL STREET
Practice Address - Street 2:HOSPITAL OF SAINT RAPHAEL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2204
Practice Address - Country:US
Practice Address - Phone:203-788-9657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital