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General NPI Number Information
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NPI Number | 1972592640
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Entity Type | Individual
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Provider Name | LINDA M CHAFFKIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 85 SEYMOUR ST SUITE 507
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City | HARTFORD
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State | CT
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Zip | 06106-5501
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Country | US
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Telephone | 860-548-1383
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Fax |
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Provider Business Mailing Address
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Address Line | 30 PENNY LN
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City | WOODBRIDGE
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State | CT
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Zip | 06525-1531
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Country | US
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Telephone | 203-494-4039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 030375
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License Number State | CT
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