Organization Active NPI

County Obstetrics and Gynecology Group

  • Obstetrics & Gynecology Physician
  • Branford, CT
National Provider Identifier
1265426332
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
COUNTY OBSTETRICS AND GYNECOLOGY GROUP
Practice address
687 Main St
Branford, CT 06405-3612
Phone
(203) 488-8306
Fax
(203) 481-0267
NPI assigned
Sep 6, 2005
Last updated
Apr 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Authorized official

Name
Mrs. Tina D'Amico, MHA
Title
Administrator
Phone
(203) 315-7071

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

687 Main St
Branford, CT 06405-3612

Mailing address

687 Main St
Branford, CT 06405-3612
Phone (203) 488-8306

Other identifiers 1

IdentifierTypeStateIssuer
004141264MedicaidCT

National Provider Directory

National Provider Directory

Locations

8 E Main St
Clinton, CT 06413
Phone (860) 669-0719

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1265426332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053612",
            "telephone_number": "203-488-8306",
            "fax_number": "203-481-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053612",
            "telephone_number": "203-488-8306",
            "fax_number": "203-481-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OBSTETRICS AND GYNECOLOGY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "D'AMICO",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "203-315-7071",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004141264",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.