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PEDIATRIC & MEDICAL ASSOCIATES P.C. NPI 1053464487


NPI Information

NPI: 1053464487
Provider Name: PEDIATRIC & MEDICAL ASSOCIATES, P.C.
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 07D0098624

Address:
1 LONG WHARF DR
SUITE 105
NEW HAVEN, CT
ZIP 06511
Phone: (203) 865-3737
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PEDIATRIC & MEDICAL ASSOCIATES, P.C. is a pediatrics in New Haven, 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. PEDIATRIC & MEDICAL ASSOCIATES, P.C. NPI is 1053464487. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 LONG WHARF DR
SUITE 105
NEW HAVEN, CT
ZIP 06511-991
Phone: (203) 865-3737
Fax: (203) 624-0751

The provider's authorized official is Ronald Angoff .
The authorized official title is President Pediatric & Medical Assoc and has the following contact phone number (203) 865-3737.

The CLIA number assigned to this NPI record is 07D0098624 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 4/25/2014.


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
1363LP0200XNurse PractitionerPediatricsNo
2208000000XPediatricsYes

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
1004001913MEDICAIDCONNECTICUT
250PEDMEDICT01OTHERBCBS ID 50PEDMEDICT01

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: 11/14/2023

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