Healthcare Provider Details
I. General information
NPI: 1154438778
Provider Name (Legal Business Name): HELEN TRYMBULAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/23/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
345 NORTH MAIN STREET SUITE 201
W HARTFORD CT
06117
US
IV. Provider business mailing address
345 N MAIN ST SUITE 201
WEST HARTFORD CT
06117-2515
US
V. Phone/Fax
- Phone: 860-561-7222
- Fax: 860-561-7228
- Phone: 860-561-7222
- Fax: 860-561-7228
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 038386 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: