Provider Demographics
NPI:1922072057
Name:CORNELL SCOTT HILL HEALTH CORPORATION
Entity Type:Organization
Organization Name:CORNELL SCOTT HILL HEALTH CORPORATION
Other - Org Name:CORNELL SCOTT HILL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PEDIARICS
Authorized Official - Prefix:DR
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-503-3403
Mailing Address - Street 1:400 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1233
Mailing Address - Country:US
Mailing Address - Phone:203-503-3000
Mailing Address - Fax:203-503-3254
Practice Address - Street 1:428 COLUMBUS AVE
Practice Address - Street 2:PEDIATRICS
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1233
Practice Address - Country:US
Practice Address - Phone:203-503-3000
Practice Address - Fax:203-503-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD80883Medicare UPIN