Provider Demographics
NPI:1528189644
Name:WOMEN'S CARE MEDICAL CENTER, PC
Entity Type:Organization
Organization Name:WOMEN'S CARE MEDICAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:NESBITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-448-6303
Mailing Address - Street 1:85 POHEGANUT DR
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3216
Mailing Address - Country:US
Mailing Address - Phone:860-448-6303
Mailing Address - Fax:860-448-9678
Practice Address - Street 1:85 POHEGANUT DR
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3216
Practice Address - Country:US
Practice Address - Phone:860-448-6303
Practice Address - Fax:860-448-9678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty