1154429884 NPI number — CENTER FOR FERTILITY AND WOMEN'S HEALTH, P.C.

Table of content: (NPI 1154429884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154429884 NPI number — CENTER FOR FERTILITY AND WOMEN'S HEALTH, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR FERTILITY AND WOMEN'S HEALTH, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154429884
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 OXFORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06032-1432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 GRAND ST
Provider Second Line Business Practice Location Address:
SUITE E-3
Provider Business Practice Location Address City Name:
NEW BRITAIN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06052-2016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-224-5467
Provider Business Practice Location Address Fax Number:
860-224-5471
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SANZARO
Authorized Official First Name:
MAGGIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
860-224-5967

Provider Taxonomy Codes

  • Taxonomy code: 207VE0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 14472394134 . This is a "NPI DR. DANIELLE LUCIANO" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1558350405 . This is a "NPI DR. ANTHONY LUCIANO" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0011711230 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1972592640 . This is a "NPI DR. CHAFFKIN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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