NPI Code Detail JSON Logo

1629330220 NPI number — CONNECTICUT REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, PC

NPI Number: 1629330220
Health Care Provider/Practitioner: CONNECTICUT REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, PC

Information about “1629330220” NPI (CONNECTICUT REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, PC) exists in 1629330220 in HTML format HTML  |  1629330220 in plain Text format TXT  |  1629330220 in PDF (Portable Document Format) PDF  |  1629330220 in an XML format XML  formats.

NPI Number : 1629330220 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629330220",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CONNECTICUT REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3810 CONGRESS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRFIELD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06824-2039",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-292-6049",
    "MailingAddressFaxNumber": "203-916-6912",
    "FirstLinePracticeLocationAddress": "115 TECHNOLOGY DR",
    "SecondLinePracticeLocationAddress": "SUITE 107B",
    "PracticeLocationAddressCityName": "TRUMBULL",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06611-6337",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-200-7117",
    "PracticeLocationAddressFaxNumber": "203-916-6912",
    "EnumerationDate": "06/11/2012",
    "LastUpdateDate": "06/11/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WILLIAMS",
    "AuthorizedOfficialFirstName": "SHAUN",
    "AuthorizedOfficialMiddleName": "CHRISTOPHER",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "203-200-7117",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207VE0102X",
        "TaxonomyName": "Reproductive Endocrinology Physician",
        "LicenseNumber": "043549",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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