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GOLD STAR PEDIATRICS LLC NPI 1033311915


NPI Information

NPI: 1033311915
Provider Name: GOLD STAR PEDIATRICS LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
495 GOLD STAR HWY
STE 495
GROTON, CT
ZIP 06340
Phone: (860) 449-8882
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GOLD STAR PEDIATRICS LLC is a pediatrics in Groton, CT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. GOLD STAR PEDIATRICS LLC NPI is 1033311915. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

495 GOLD STAR HWY
STE 495
GROTON, CT
ZIP 06340-228
Phone: (860) 449-8882
Fax: (860) 449-9195

The provider's authorized official is Michael Blefeld .
The authorized official title is Owner and has the following contact phone number (860) 449-8882.

The enumeration date for this NPI number is 6/4/2007 and was last updated on 12/29/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics22070CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004395530MEDICAIDCONNECTICUT
2004238227MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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