Organization Name: | ELLINGTON OBSTETRICS & GYNECOLOGY ASSOCIATES, P.C. |
NPI Number: | 1770617409 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LENORA S WILLIAMS (PRESIDENT) |
Mailing Address: | 105 West Rd Ellington |
State: | CT US |
Postal Code: | 060293777 |
Phone Number: | 8608727854 |
Fax Number: | 8608707944 |
NPI Enumeration Date: | 03/15/2007 |
NPI Last Update Date: | 07/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |