# SPECIALISTS IN WOMEN'S HEALTHCARE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114928827
- **Authorized official:** MR. JOHN CONRAD KACZMAREK MD (MD PRESIDENT)
- **Authorized official phone:** (203) 754-2535

## Contact information

- **Practice address:** 134 GRANDVIEW AVE, STE 210, WATERBURY, CT 06708-2507
- **Practice address phone:** (203) 754-2535
- **Practice address fax:** (203) 754-0788
- **Mailing address:** 134 GRANDVIEW AVE, STE 210, WATERBURY, CT 06708-2507
- **Mailing address phone:** (203) 754-2535
- **Mailing address fax:** (203) 754-0788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | NULL | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 08/03/2005
- **Last updated:** 04/18/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004190310 | — | CT |