| Aids Project New Haven, Inc | |
|
1302 Chapel St New Haven CT 06511-4515 | |
| (203) 624-0947 | |
| (203) 401-4457 |
| Full Name | Aids Project New Haven, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1302 Chapel St, New Haven, Connecticut |
| Authorized Official Name and Position | Christopher Allen Cole (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2036240947 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aids Project New Haven, Inc 1302 Chapel St New Haven CT 06511-4515 Ph: (203) 624-0947 | Aids Project New Haven, Inc 1302 Chapel St New Haven CT 06511-4515 Ph: (203) 624-0947 |
| NPI Number | 1184993081 |
|---|---|
| Provider Enumeration Date | 12/21/2011 |
| Last Update Date | 07/23/2012 |
| Medicare PECOS PAC ID | 6901128776 |
|---|---|
| Medicare Enrollment ID | O20141205000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184993081 | NPI | - | NPPES |
| Provider Name | Gretchen L Hermes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710161948 PECOS PAC ID: 2567614332 Enrollment ID: I20121203000080 |
| Provider Name | Richard Radocchia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265713168 PECOS PAC ID: 1254575764 Enrollment ID: I20130924000551 |
| Provider Name | Madonna Fasula |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1053626929 PECOS PAC ID: 9032421797 Enrollment ID: I20150709000229 |
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