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General NPI Number Information
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NPI Number | 1366621815
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Entity Type | Organization
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Legal Business Name | FAIRFIELD COUNTY WOMEN'S HEALTH ASSOCIATES, P.C.
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 2590 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06615-5838
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Country | US
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Telephone | 203-375-3665
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Fax | 203-378-1340
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Provider Business Mailing Address
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Address Line | 2590 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06615-5838
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Country | US
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Telephone | 203-375-3665
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Fax | 203-378-1340
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARYANNE YAKOUBIAN
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Credential |
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Telephone | 203-375-3665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 027973
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License Number State | CT
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