Healthcare Provider Details

I. General information

NPI: 1104747278
Provider Name (Legal Business Name): WOMEN'S HEALTH OF GREENWICH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 HOLLY HILL LN STE 103
GREENWICH CT
06830-6098
US

IV. Provider business mailing address

75 HOLLY HILL LN STE 103
GREENWICH CT
06830-6098
US

V. Phone/Fax

Practice location:
  • Phone: 203-822-6749
  • Fax: 203-822-6749
Mailing address:
  • Phone: 203-822-6749
  • Fax: 203-822-6749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: CALEB MOORE
Title or Position: OWNER
Credential: MD
Phone: 203-822-6749