Connecticut Reproductive Endocrinology and Infertility, PC

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

043549 Issued in CT

Legal business name

CONNECTICUT REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, PC

Practice address

115 Technology Dr
Suite 107B
Trumbull, CT 06611-6337

Phone

(203) 200-7117

Fax

(203) 916-6912

NPI assigned

Jun 11, 2012

Last updated

Jun 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shaun Christopher Williams, M.D.

Title

President

Phone

(203) 200-7117

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1629330220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 CONGRESS ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068242039",
            "telephone_number": "203-292-6049",
            "fax_number": "203-916-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR",
            "address_2": "SUITE 107B",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116337",
            "telephone_number": "203-200-7117",
            "fax_number": "203-916-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-200-7117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CT",
            "license": "043549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.