Provider Demographics
NPI:1487470274
Name:PHYSICIANS FOR WOMEN'S HEALTH, LLC
Entity type:Organization
Organization Name:PHYSICIANS FOR WOMEN'S HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOTTSCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-374-0404
Mailing Address - Street 1:175 CAPITAL BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6032
Practice Address - Country:US
Practice Address - Phone:203-748-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIANS FOR WOMEN'S HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing