Provider Demographics
NPI:1023201753
Name:AFFILIATES IN WOMEN'S CARE LLC
Entity Type:Organization
Organization Name:AFFILIATES IN WOMEN'S CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-366-5968
Mailing Address - Street 1:309 STILLSON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3213
Mailing Address - Country:US
Mailing Address - Phone:206-366-8700
Mailing Address - Fax:203-367-8080
Practice Address - Street 1:309 STILLSON RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3213
Practice Address - Country:US
Practice Address - Phone:206-366-8700
Practice Address - Fax:203-367-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004208147Medicaid
CTC02676Medicare PIN