Provider Demographics
NPI:1952649097
Name:YALE UNIVERSITY
Entity Type:Organization
Organization Name:YALE UNIVERSITY
Other - Org Name:YALE THERAPEUTIC RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF REVENUE OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESS-SANTORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-785-4120
Mailing Address - Street 1:PO BOX 9805
Mailing Address - Street 2:300 GEORGE ST 6TH FLR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06536-0805
Mailing Address - Country:US
Mailing Address - Phone:203-785-2140
Mailing Address - Fax:203-785-6414
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-200-2100
Practice Address - Fax:203-200-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Multi-Specialty