Provider Demographics
NPI:1144549353
Name:ADVANCED OB-GYN DOCTORS
Entity type:Organization
Organization Name:ADVANCED OB-GYN DOCTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAVANI REDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PINGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-313-1486
Mailing Address - Street 1:20 DEER RUN DR
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 DEER RUN DR
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-3140
Practice Address - Country:US
Practice Address - Phone:860-313-1486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048077207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty