Organization
OBGYN GROUP OF EASTERN CONNECTICUT, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY RICCITELLI (ADMINISTRATOR)
(860) 646-1157
Entity
Organization
Contact information
Practice address
2600 TAMARACK AVENUE, SUITE 200, SOUTH WINDSOR, CT 06074-5560
(860) 646-1157
(860) 646-9877
Mailing address
2600 TAMARACK AVENUE, SUITE 200, SOUTH WINDSOR, CT 06074-5560
(860) 646-1157
(860) 646-9877
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004394251
—
CT
Enumeration date
05/08/2007
Last updated
01/22/2020
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