Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 062242 | CT |
N | 207VE0102X | Reproductive Endocrinologist | 62242 | CT |
NPI | 1417335415 |
---|---|
Provider Name | Dr. Prachi Nitin Godiwala |
First Address | Farmington, CT 06032-2568 |
Second Address | Farmington, CT 06032-2568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2015 |
Last Update Date | 13/09/2019 |