Healthcare Provider Details

I. General information

NPI: 1407837610
Provider Name (Legal Business Name): ELLEN CATHERINE DENIGRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROUT 12 BLDG 449 NAVAL AMBULATORY CARE CENTER ATTN: PROFESSIONAL AFFAIRS
GROTON CT
06349-5600
US

IV. Provider business mailing address

ROUT 12 BLDG 449 NAVAL AMBULATORY CARE CENTER ATTN: PROFESSIONAL AFFAIRS
GROTON CT
06349-5600
US

V. Phone/Fax

Practice location:
  • Phone: 860-694-2377
  • Fax: 860-694-2590
Mailing address:
  • Phone: 860-694-2377
  • Fax: 860-694-2590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0036711
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberD0036711
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: