Provider Type Icon

HER TRANSFORMATION OBGYN PLLC NPI 1104391598


NPI Information

NPI: 1104391598
Provider Name: HER TRANSFORMATION OBGYN, PLLC

Doing Business As: HER TRANSFORMATION OBGYN

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 07D2156611

Address:
2228 BLACK ROCK TPKE STE 211
FAIRFIELD, CT
ZIP 06825
Phone: (475) 888-0099
Get Directions

HER TRANSFORMATION OBGYN, PLLC is an obstetrics gynecology in Fairfield, CT. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. HER TRANSFORMATION OBGYN, PLLC NPI is 1104391598. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Her Transformation Obgyn.

The provider's business location address is:

2228 BLACK ROCK TPKE STE 211
FAIRFIELD, CT
ZIP 06825-237
Phone: (475) 888-0099

The provider's authorized official is Valentine Edusa .
The authorized official title is Founder/managing Member and has the following contact phone number (475) 888-0099.

The CLIA number assigned to this NPI record is 07D2156611 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/11/2018 and was last updated on 5/10/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.