Basic Information
| Provider Information | |||||||||
| NPI: | 1992887491 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 208032 | ||||||||
| Address2: | 333 CEDAR STREET/MEDICAL ONCOLOGY | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065208032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037371600 | ||||||||
| FaxNumber: | 2037853788 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 CEDAR STREET | ||||||||
| Address2: | MEDICAL ONCOLOGY | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065208032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037371600 | ||||||||
| FaxNumber: | 2037853788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 02/06/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 051021 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.