NPIMap

Organization Active NPI

Advanced Gynecology Consultants of New England, LLC

  • Gynecology Physician
  • Putnam, CT
National Provider Identifier
1003122011
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
036115 Issued in CT
Legal business name
ADVANCED GYNECOLOGY CONSULTANTS OF NEW ENGLAND, LLC
Practice address
333 Pomfret St
Putnam, CT 06260-1852
Phone
(860) 963-0808
Fax
(860) 928-6738
NPI assigned
Aug 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ronald C Archibold, MD
Title
Owner
Phone
(860) 963-0808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 036115 CT Primary

Addresses

Primary practice location

333 Pomfret St
Putnam, CT 06260-1852

Mailing address

PO Box 569
Putnam, CT 06260-0569
Phone (860) 963-0808

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1003122011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062600569",
            "telephone_number": "860-963-0808",
            "fax_number": "860-928-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601852",
            "telephone_number": "860-963-0808",
            "fax_number": "860-928-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GYNECOLOGY CONSULTANTS OF NEW ENGLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "ARCHIBOLD",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-963-0808",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CT",
            "license": "036115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.