Healthcare Provider Details

I. General information

NPI: 1316001324
Provider Name (Legal Business Name): CONNECTICUT OB-GYN,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 BURNSIDE AVE
EAST HARTFORD CT
06108-3405
US

IV. Provider business mailing address

27 BURNSIDE AVE
EAST HARTFORD CT
06108-3405
US

V. Phone/Fax

Practice location:
  • Phone: 860-761-1234
  • Fax: 203-413-6229
Mailing address:
  • Phone: 860-761-1234
  • Fax: 203-413-6229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateCT

VIII. Authorized Official

Name: PARESH LIMAYE
Title or Position: OWNER
Credential: M.D.
Phone: 860-761-1234