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PEDIATRIC CARE ASSOCIATES OF CONNECTICUT NPI 1396867958


NPI Information

NPI: 1396867958
Provider Name: PEDIATRIC CARE ASSOCIATES OF CONNECTICUT
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 07D0717051

Address:
25 CONSTITUTION BLVD. SO
PEDI-CARE
SHELTON, CT
ZIP 06484
Phone: (203) 924-7334
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PEDIATRIC CARE ASSOCIATES OF CONNECTICUT is an adolescent medicine pediatrics in Shelton, CT. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. PEDIATRIC CARE ASSOCIATES OF CONNECTICUT NPI is 1396867958. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

25 CONSTITUTION BLVD. SO
PEDI-CARE
SHELTON, CT
ZIP 06484-300
Phone: (203) 924-7334
Fax: (203) 922-0004

The provider's authorized official is Marie Leclerc .
The authorized official title is Office Manager and has the following contact phone number (203) 924-7334.

The CLIA number assigned to this NPI record is 07D0717051 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2007 and was last updated on 7/21/2022.


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
12080A0000XPediatricsAdolescent MedicineCONNECTICUTYes

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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