# AVERY CENTER FOR OBGYN PC

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

## Provider details

- **NPI number:** 1922175587
- **Authorized official:** DR. DENIS SIVAK MD (CEO)
- **Authorized official phone:** (203) 227-5125

## Contact information

- **Practice address:** 12 AVERY PL, WESTPORT, CT 06880-3223
- **Practice address phone:** (203) 227-5125
- **Practice address fax:** (203) 222-7180
- **Mailing address:** 12 AVERY PL, WESTPORT, CT 06880-3223
- **Mailing address phone:** (203) 227-5125
- **Mailing address fax:** (203) 222-7180

## Taxonomy

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

## Other

- **Enumeration date:** 11/29/2006
- **Last updated:** 01/19/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 02400 | SHELLEY GIBSON | CT |