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Organization
STATE OF CONNECTICUT HEALTH CENTER
Active
Organization
STATE OF CONNECTICUT HEALTH CENTER
Active
Parent organization
STATE OF CONNECTICUT HEALTH CENTER
Other names
OB/GYN HBP Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF CONNECTICUT HEALTH CENTER
Authorized official
DENIS C LAFRENIERE MD (MEDICAL DIRECTOR)
(860) 679-7503
Entity
Organization
Contact information
Practice address
263 FARMINGTON AVE, OB/GYN HBP GROUP, FARMINGTON, CT 06030-0001
(860) 679-7503
(860) 679-1610
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT - DOWLING SOUTH, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
05/27/2008
Last updated
06/15/2012
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