Provider Demographics
NPI:1720314164
Name:FUCHS, YONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:YONATHAN
Middle Name:
Last Name:FUCHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1369
Mailing Address - Country:US
Mailing Address - Phone:203-785-4649
Mailing Address - Fax:
Practice Address - Street 1:800 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-4649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2442322080P0206X
FLME1189422080P0206X
CT686882080T0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080T0004XAllopathic & Osteopathic PhysiciansPediatricsPediatric Transplant Hepatology
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03251365Medicaid
NYA400060674Medicare PIN
NY03251365Medicaid