Basic Information
| Provider Information | |||||||||
| NPI: | 1891797213 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KASRAIAN | ||||||||
| FirstName: | PARVIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35 PECK HILL RD | ||||||||
| Address2: | |||||||||
| City: | WOODBRIDGE | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065251301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033973739 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1441 CHAPEL ST | ||||||||
| Address2: | CENTER FOR WOMEN HEALTH AND MIDWIFERY | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065114403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037893029 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 10/15/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | 000089 | CT | Y | Other Service Providers | Midwife |
No ID Information.