Basic Information
| Provider Information | |||||||||
| NPI: | 1891806535 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VETERANS HEALTHCARE SYSTEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 195 ARCH ST | ||||||||
| Address2: | #3 | ||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065144800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037768523 | ||||||||
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| Practice Location | |||||||||
| Address1: | 950 CAMPBELL AVE | ||||||||
| Address2: | |||||||||
| City: | WEST HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065162770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039325711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 06/23/2008 | ||||||||
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| AuthorizedOfficialLastName: | DANZYRUDD | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | REGISTERED NURSE | ||||||||
| AuthorizedOfficialTelephone: | 2039325711 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | R45299 | CT | Y | Hospitals | General Acute Care Hospital |
No ID Information.