# ADVANCED GYNECOLOGY & ROBOTIC SURGEY, LLC

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

## Provider details

- **NPI number:** 1699026724
- **Authorized official:** DR. SHABNAM M KASHANI M.D (OWNER)
- **Authorized official phone:** (203) 374-8000

## Contact information

- **Practice address:** 4637 MAIN STREET, BRIDGEPORT, CT 06606-5048
- **Practice address phone:** (203) 374-8000
- **Mailing address:** 4637 MAIN STREET, BRIDGEPORT, CT 06606-5048
- **Mailing address phone:** (203) 374-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VG0400X | Gynecology Physician | 045088 | CT | — |

## Other

- **Enumeration date:** 09/28/2012
- **Last updated:** 10/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 045088 | STATE LICENSE | CT |