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General NPI Number Information
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NPI Number | 1164895314
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Entity Type | Organization
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Legal Business Name | NAUGATUCK VALLEY WOMENS HEALTH SPECIALISTS PC
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 686 STRAITS TURNPIKE 2A
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City | MIDDLEBURY
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State | CT
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Zip | 06762
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Country | US
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Telephone | 203-575-1811
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Fax | 203-575-1995
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Provider Business Mailing Address
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Address Line | 686 STRAITS TURNPIKE 2A
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City | MIDDLEBURY
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State | CT
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Zip | 06762
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Country | US
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Telephone | 203-575-1811
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Fax | 203-575-1995
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Authorized Official
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Title or Position | MEDICAL ASSISTNAT
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Name | NADINE PENDARVIS
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Credential | MD
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Telephone | 203-575-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 054319
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License Number State | CT
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