Organization
STAMFORD GYNECOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER A GOODHUE MD (MD PRESIDENT)
(203) 359-3340
Entity
Organization
Contact information
Practice address
70 MILL RIVER ST, STAMFORD, CT 06902
(203) 359-3340
(203) 359-4515
Mailing address
70 MILL RIVER ST, STAMFORD, CT 06902
(203) 359-3340
(203) 359-4515
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
9645
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010009645CT01
ANTHEM
—
01
—
022258
HEALTHNET
—
01
—
2152738
AETNA
—
01
—
774778
CONNECTICARE
—
01
—
CT0000025
SELECT PRO
—
01
—
ZP286
OXFORD
—
Enumeration date
09/30/2006
Last updated
08/22/2020
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