Streeter, Gordon Chase
Streeter, Gordon Chase is an individual health care provider with primary practice located at 55 Lock St , New Haven CT 06511-3603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Streeter, Gordon Chase can be contacted via phone (203) 432-0206.Contact Information
Primary practice address
55 Lock St
New Haven CT 06511-3603
Phone: (203) 432-0206
Fax: (203) 432-0072
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 043348 | Connecticut |
Profile Details
| NPI number | 1669432258 |
|---|---|
| LBN Legal business name | Streeter, Gordon Chase |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 27th, 2006 |
| Last updated | Oct 6th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669432258 | NPPES |
| Connecticut | MEDICAID | 001433482 | |
| Connecticut | Other | 010043348CT01 | |
| Connecticut | Other | 061511900 |
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