Provider Demographics
NPI:1144260548
Name:STANWOOD, NANCY L (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:STANWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CEDAR ST # 320
Mailing Address - Street 2:OBGYN
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3218
Mailing Address - Country:US
Mailing Address - Phone:203-737-4665
Mailing Address - Fax:203-737-6195
Practice Address - Street 1:310 CEDAR ST # 320
Practice Address - Street 2:OBGYN
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3218
Practice Address - Country:US
Practice Address - Phone:203-737-4665
Practice Address - Fax:203-737-6195
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221265207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02162976Medicaid
NYJ400001775Medicare PIN
NYCC6595Medicare PIN
NYJ400042939Medicare PIN