STATE OF CONNECTICUT HEALTH CENTER

FARMINGTON, CT
NPI1811155849
Other NameOB/GYN HBP GROUP
Entity TypeOrganization
Authorized ContactDENIS C LAFRENIERE
Medical Director
860-679-7503
Organization Subpart ?Yes
Primary Taxonomy207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine
Enumeration Date2008-05-27
Last Update Date2012-06-15
Business Address
STATE OF CONNECTICUT HEALTH CENTER
263 FARMINGTON AVE OB/GYN HBP GROUP
FARMINGTON, CT 06030-0001
Phone number: 860-679-7503
Mailing Address
STATE OF CONNECTICUT HEALTH CENTER
263 FARMINGTON AVE PROVIDER ENROLLMENT - DOWLING SOUTH
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503