MEDICARE: PARVIN KASRAIAN CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	000089	CT

General Provider Information

NPI Number	:	1891797213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARVIN KASRAIAN CNM

Provider Business Mailing Address
First Line	:	35 PECK HILL RD
Second Line	:
City	:	WOODBRIDGE
State	:	CT
Zip	:	06525-1301
Country	:	US
Telephone Number	:	203-397-3739
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 CHAPEL ST
Second Line	:	CENTER FOR WOMEN HEALTH AND MIDWIFERY
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-4403
Country	:	US
Telephone Number	:	203-789-3029
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	10/15/2007

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