Provider Demographics
NPI:1487112819
Name:GREENFIELD, CAROLYN CONSTANCE
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:CONSTANCE
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BILLINGS RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-1924
Mailing Address - Country:US
Mailing Address - Phone:860-763-1196
Mailing Address - Fax:
Practice Address - Street 1:76 BILLINGS RD
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:CT
Practice Address - Zip Code:06071-1924
Practice Address - Country:US
Practice Address - Phone:860-763-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty