Provider Demographics
NPI:1295826691
Name:WORGAFTIK, BRIGITTE (MD)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:
Last Name:WORGAFTIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W AVON RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001
Mailing Address - Country:US
Mailing Address - Phone:860-673-4670
Mailing Address - Fax:860-673-4584
Practice Address - Street 1:20 W AVON RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001
Practice Address - Country:US
Practice Address - Phone:860-673-4670
Practice Address - Fax:860-673-4584
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027256207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001272566Medicaid
B83238Medicare UPIN
160001860Medicare ID - Type Unspecified