# COUNTY OBSTETRICS AND GYNECOLOGY GROUP

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

## Provider details

- **NPI number:** 1265426332
- **Authorized official:** MRS. TINA D'AMICO MHA (ADMINISTRATOR)
- **Authorized official phone:** (203) 315-7071

## Contact information

- **Practice address:** 687 MAIN ST, BRANFORD, CT 06405-3612
- **Practice address phone:** (203) 488-8306
- **Practice address fax:** (203) 481-0267
- **Mailing address:** 687 MAIN ST, BRANFORD, CT 06405-3612
- **Mailing address phone:** (203) 488-8306
- **Mailing address fax:** (203) 481-0267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2005
- **Last updated:** 04/08/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004141264 | — | CT |