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General NPI Number Information
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NPI Number | 1225298425
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Entity Type | Organization
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Legal Business Name | PRIVATE OB GYN ASSOCIATES
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 1488 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4332
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Country | US
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Telephone | 203-562-9939
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Fax | 203-782-2476
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Provider Business Mailing Address
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Address Line | 1488 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4332
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Country | US
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Telephone | 203-562-9939
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Fax | 203-782-2476
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | MR. ERIC C PALLUOTTO
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Credential | M.D.
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Telephone | 203-562-9939
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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 | 24728
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License Number State | CT
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