Provider Demographics
NPI:1427067578
Name:SUMMIT MEDICAL CENTER INC
Entity type:Organization
Organization Name:SUMMIT MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SERVICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:UMBRICHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-259-8782
Mailing Address - Street 1:61 UNQUOWA RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5096
Mailing Address - Country:US
Mailing Address - Phone:203-259-8782
Mailing Address - Fax:203-259-0834
Practice Address - Street 1:360 MARKET ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-2901
Practice Address - Country:US
Practice Address - Phone:860-493-6575
Practice Address - Fax:860-493-6583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0013207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTAETNAOtherAETNA
CTA394805OtherOXFORD HEALTH
CTOV6680OtherHEALTHNET
CT992953OtherCONNECTICARE
CT992953OtherCONNECTICARE