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

LicenseStateTypeSpecialty
26245CTMDGynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
001262450MedicaidCT

Other providers in Groton, CT

All providers in Groton, CT · Obstetrics & Gynecology Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.