Provider Demographics
NPI:1255524542
Name:OBSTETRICS AND GYNECOLOGY OF FAIRFIELD COUNTY, LLC
Entity type:Organization
Organization Name:OBSTETRICS AND GYNECOLOGY OF FAIRFIELD COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:VANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-256-3379
Mailing Address - Street 1:1735 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5782
Mailing Address - Country:US
Mailing Address - Phone:203-256-3990
Mailing Address - Fax:203-256-3993
Practice Address - Street 1:1735 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5782
Practice Address - Country:US
Practice Address - Phone:203-256-3990
Practice Address - Fax:203-256-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty