Peter T Auerbach, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Groton, CT
NPI 1154412674 · NPPES record last updated Feb 1, 2013
Key facts
- NPI
- 1154412674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 26245 (CT)
- Practice address
- 491 Gold Star Hwy
Ste 100
Groton, CT 06340 - Phone
- (860) 445-5107
- Fax
- (860) 448-1368
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26245 | CT | MD | Gynecology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 26245 | CT | Yes |
| Gynecology Physician | 207VG0400X | 26245 | CT | |
| Obstetrics Physician | 207VX0000X | 26245 | CT |
Addresses
Primary practice location
491 Gold Star Hwy
Ste 100
Groton, CT 06340
Mailing address
491 Gold Star Hwy
Ste 100
Groton, CT 06340-6226
Phone (860) 445-5107
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001262450 | Medicaid | CT |
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- Kyrah Augmon-Bossa
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- Brianna Ba
- Jennifer N Back
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All providers in Groton, CT · Obstetrics & Gynecology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.