PEDIATRIC ASSOCIATES LLC NPI 1295920015

NPI Information

NPI: 1295920015
Provider Name: PEDIATRIC ASSOCIATES, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 07D0709816

Address:
10 N MAIN ST
BRISTOL, CT
ZIP 06010
Phone: (860) 589-5230
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PEDIATRIC ASSOCIATES, LLC is a primary care clinic center in Bristol, CT. PEDIATRIC ASSOCIATES, LLC NPI is 1295920015. The provider is registered as an organization entity type.

The provider's business location address is:

10 N MAIN ST
BRISTOL, CT
ZIP 06010-102
Phone: (860) 589-5230
Fax: (860) 589-5297

The provider's authorized official is Maria I Lopez .
The authorized official title is Practice Manager and has the following contact phone number (860) 589-5238.

The CLIA number assigned to this NPI record is 07D0709816 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/14/2007 and was last updated on 9/14/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	1896539000	CONNECTICUT	Yes

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: 5/5/2024

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