Provider Demographics
NPI:1639563216
Name:INTEGRAMED MEDICAL CONNECTICUT, LLC
Entity type:Organization
Organization Name:INTEGRAMED MEDICAL CONNECTICUT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HYACINTH
Authorized Official - Middle Name:N
Authorized Official - Last Name:BROWNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-794-0073
Mailing Address - Street 1:5320 S RAINBOW BLVD
Mailing Address - Street 2:SUITE300
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1895
Mailing Address - Country:US
Mailing Address - Phone:702-794-0073
Mailing Address - Fax:702-794-0042
Practice Address - Street 1:100 TECHNOLOGY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6303
Practice Address - Country:US
Practice Address - Phone:702-794-0073
Practice Address - Fax:702-794-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257332207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty