Healthcare Provider Details

I. General information

NPI: 1427067578
Provider Name (Legal Business Name): SUMMIT MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 MARKET ST
HARTFORD CT
06120-2901
US

IV. Provider business mailing address

61 UNQUOWA RD
FAIRFIELD CT
06824-5096
US

V. Phone/Fax

Practice location:
  • Phone: 860-493-6575
  • Fax: 860-493-6583
Mailing address:
  • Phone: 203-259-8782
  • Fax: 203-259-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0013
License Number StateCT

VIII. Authorized Official

Name: JANIE UMBRICHT
Title or Position: INSURANCE SERVICE DIRECTOR
Credential:
Phone: 203-259-8782