FAIR HAVEN COMMUNITY HEALTH CLINIC, INC (NPI# 1447767934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447767934 |
| Entity Type | Organization |
| Organization Name | FAIR HAVEN COMMUNITY HEALTH CLINIC, INC |
| Practice Address |
14 Sycamore Way Branford CT 06405-6551 |
| Mailing Address |
374 Grand Ave New Haven CT 06513-3733 |
| Practice Telephone | 2037777411 |
| Practice Fax Number | 2037778506 |
| Mailing Telephone | 2037525248 |
| Mailing Fax Number | 2037863004 |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |
| Authorized Official Name | YOLYMAR HERRERA (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2037777411 |
| Is Organization Subpart | Y |
| Parent Organization Name | FAIR HAVEN COMMUNITY HEALTH CLINIC, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
0901 | CT | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588263016 | Fair Haven Community Health Clinic, Inc | Clinic/Center | 150 Sargent Dr Ste 1-300, New Haven, CT 06511-6100 | 2020-10-26 |
| 1043679863 | Fair Haven Community Health Clinic, Inc | Clinic/Center | 426 East St, New Haven, CT 06511-5018 | 2016-02-22 |
| 1568832640 | Fair Haven Community Health Clinic, Inc | Family Medicine | 370 Hemingway Ave, East Haven, CT 06512-3240 | 2015-10-01 |
| 1811372469 | Fair Haven Community Health Clinic, Inc | Dentist | 50 Grand Ave, New Haven, CT 06513-3949 | 2015-07-24 |
| Street Address |
14 SYCAMORE WAY |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405-6551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255305561 | Anthony Corniello | Social Worker | 14 Sycamore Way, Branford, CT 06405-6551 | 2006-02-14 |
| 1992306179 | Angela Marie Pascale | Social Worker | 14 Sycamore Way, Branford, CT 06405-6551 | 2020-11-04 |
| 1366907495 | Julie Ann Cosenza | Counselor | 14 Sycamore Way, Branford, CT 06405-6551 | 2019-02-03 |
| 1598246225 | Tara Victoria Butricks | Social Worker | 14 Sycamore Way, Branford, CT 06405-6551 | 2018-08-21 |
| 1407349368 | Louis M Bruni Jr. | Social Worker | 14 Sycamore Way, Branford, CT 06405-6551 | 2018-06-14 |
| 1184121568 | Aaron S Price | Social Worker | 14 Sycamore Way, Branford, CT 06405 | 2018-04-11 |
| 1821512260 | Marielle Daddona | Social Worker | 14 Sycamore Way, Branford, CT 06405-6551 | 2017-07-27 |
| 1710345327 | Rachel Cushion | Social Worker | 14 Sycamore Way, Branford, CT 06405 | 2016-02-10 |
| 1386026979 | Patricia Magida | Counselor | 14 Sycamore Way, Branford, CT 06405-6551 | 2015-06-19 |
| 1336537794 | Meryl Caren Boyarsky | Counselor | 14 Sycamore Way, Branford, CT 06405-6551 | 2015-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770119596 | Katarzyna Pavelko | Physical Therapist | Branford Hills, 189 Alps Rd, Branford, CT 06405 | 2020-03-13 |
| 1174027213 | C & M Health Services Branford LLC | Home Health | 625 East Main Street, Branford, CT 06405 | 2018-03-22 |
| 1689181554 | Erin H Mccarthy | Social Worker | 513 Leetes Island Rd, Branford, CT 06405 | 2018-01-02 |
| 1255860516 | Sylcom Angelscare LLC | In Home Supportive Care | 1204 Main Street #241, Branford, CT 06405 | 2017-06-08 |
| 1093266439 | Emmanuel Chery | Physical Therapy Assistant | 153 Austin Ryer Lane, Branford, CT 06405 | 2016-10-20 |
| 1114389681 | Suraj Patel | Pharmacist | 2-6 Short Beach Rd, Branford, CT 06405 | 2016-03-24 |
| 1558753897 | Donald Ray Sirry | Social Worker | 9 Business Park Drive, Unit 1, Branford, CT 06405 | 2015-02-24 |
| 1952679110 | Maria Rivera Heath Lmft, LLC | Marriage & Family Therapist | 388 East Main Street, Suite 19, Branford, CT 06405 | 2011-12-02 |
| 1942587035 | Kathryn Lyn Delia | Pharmacist | 329 East Main St, Branford, CT 06405 | 2011-11-03 |
| 1447554068 | Elizabeth's Home Health Care Agency L.L.C. | Home Health | 127 Cedar Street, Bronford, CT 06405 | 2010-12-23 |
| Find all providers in zip 06405 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508048596 | Trenton Medical Center Inc | Clinic/Center | 103 U.S. Highway 27 Sw, Branford, FL 32008-3048 | 2007-11-30 |
| 1003450347 | Fair Haven Community Health Clinic Inc. | Clinic/Center | 221 W Main St, Branford, CT 06405-4022 | 2019-10-30 |
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| 1548861024 | Staywell Health Care Inc | Clinic/Center | 160 Robbins St Ste 2, Waterbury, CT 06708-2652 | 2020-11-03 |
| 1447719091 | Charter Oak Health Center, Inc. | Clinic/Center | 693 Bloomfield Ave Ste 101, Bloomfield, CT 06002-2489 | 2019-03-13 |
| 1811480403 | First Choice Health Centers, Inc. | Clinic/Center | 150 N Main St Ste 230, Manchester, CT 06042-2086 | 2018-06-08 |
| 1851883458 | First Choice Health Centers, Inc. | Clinic/Center | 227 Middle Turnpike East, Manchester, CT 06040-4261 | 2018-05-31 |
| 1003332446 | Community Health Center Inc | Clinic/Center | 41 New St, Danbury, CT 06810-6512 | 2017-08-17 |
| 1225559826 | First Choice Health Centers, Inc. | Clinic/Center | 809 Main Street, East Hartford, CT 06108 | 2017-07-05 |
| 1760877864 | First Choice Health Centers, Inc. | Clinic/Center | 94 Connecticut Boulevard, East Hartford, CT 06108 | 2015-04-06 |
| 1669874855 | First Choice Health Centers, Inc. | Clinic/Center | 20 Maple Street, Maple Street School, Vernon, CT 06066 | 2014-09-19 |
| 1669874087 | First Choice Health Centers, Inc. | Clinic/Center | 70 Loveland Hill Road, Rockville High School, Vernon, CT 06066 | 2014-09-17 |
| 1548677982 | Community Health Center Inc | Clinic/Center | 730 State Pier Rd, New London, CT 06320-5862 | 2014-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.