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CHILD & ADOLESCENT HEALTH CARE NPI 1497937411


NPI Information

NPI: 1497937411
Provider Name: CHILD & ADOLESCENT HEALTH CARE
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 07D0100149

Address:
179 ROSELAND AVE
WATERBURY, CT
ZIP 06710
Phone: (203) 574-4747
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CHILD & ADOLESCENT HEALTH CARE is a pediatrics in Waterbury, 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. CHILD & ADOLESCENT HEALTH CARE NPI is 1497937411. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

179 ROSELAND AVE
WATERBURY, CT
ZIP 06710
Phone: (203) 574-4747
Fax: (203) 574-2251

The provider's authorized official is Jane Rudolph .
The authorized official title is Owner and has the following contact phone number (203) 574-4747.

The CLIA number assigned to this NPI record is 07D0100149 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/30/2007 and was last updated on 3/30/2012.


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
1208000000XPediatrics000431CONNECTICUTYes

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
14049987MEDICAIDCONNECTICUT

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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