Healthcare Provider Details

I. General information

NPI: 1053450361
Provider Name (Legal Business Name): WOODLAND WOMEN'S SERVICES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 WOODLAND ST STE 112
HARTFORD CT
06105-4318
US

IV. Provider business mailing address

PO BOX 151
NORTH GRANBY CT
06060-0151
US

V. Phone/Fax

Practice location:
  • Phone: 860-278-7998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. FRED B FEINS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 860-653-0048