Provider Demographics
NPI:1255229290
Name:YALE NEW HAVEN HEALTH SERVICES CORPORATION
Entity type:Organization
Organization Name:YALE NEW HAVEN HEALTH SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-547-4584
Mailing Address - Street 1:33 OLD TAVERN RD APT 129
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3457
Mailing Address - Country:US
Mailing Address - Phone:717-753-2332
Mailing Address - Fax:
Practice Address - Street 1:1450 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4405
Practice Address - Country:US
Practice Address - Phone:203-789-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty