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:
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Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669432258 NPPES
Connecticut MEDICAID 001433482
Connecticut Other 010043348CT01
Connecticut Other 061511900

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