Provider Demographics
NPI:1891019675
Name:MILL HILL MEDICAL CONSULTANTS INC
Entity Type:Organization
Organization Name:MILL HILL MEDICAL CONSULTANTS INC
Other - Org Name:NORTHEAST MEDICAL GROUP YNH GERIATRIC SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-384-3394
Mailing Address - Street 1:874 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1106
Mailing Address - Country:US
Mailing Address - Phone:203-688-8200
Mailing Address - Fax:203-688-8204
Practice Address - Street 1:874 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1106
Practice Address - Country:US
Practice Address - Phone:203-688-8200
Practice Address - Fax:203-688-8204
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILL HILL MEDICAL CONSULTANTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-23
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty