Provider Demographics
NPI:1801872510
Name:YAGGI, HENRY KLAR (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:KLAR
Last Name:YAGGI
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 1:789 HOWARD AVE
Mailing Address - Street 2:WINCHESTER CHEST CLINIC, FITKIN BLDG., 2ND FL
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1304
Mailing Address - Country:US
Mailing Address - Phone:203-785-4198
Mailing Address - Fax:203-785-3826
Practice Address - Street 1:789 HOWARD AVE
Practice Address - Street 2:WINCHESTER CHEST CLINIC, FITKIN BLDG., 2ND FL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1304
Practice Address - Country:US
Practice Address - Phone:203-785-4198
Practice Address - Fax:203-785-3826
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT037989207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001379892Medicaid
CT001379892Medicaid
CT110007974Medicare ID - Type Unspecified