Healthcare Provider Details

I. General information

NPI: 1235220963
Provider Name (Legal Business Name): LINDA TAYLOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 FARMINGTON AVENUE SUITE 220
FARMINGTON CT
06032
US

IV. Provider business mailing address

499 FARMINGTON AVENUE SUITE 220
FARMINGTON CT
06032
US

V. Phone/Fax

Practice location:
  • Phone: 860-676-8111
  • Fax: 860-677-2693
Mailing address:
  • Phone: 860-676-8111
  • Fax: 860-677-2693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number026457
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: