| NPI | 1669448882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI ALLEN-DUNN Director, Credentialing 860-837-5561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207N00000X Dermatology |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine | |
| 2080P0205X Pediatrics, Pediatric Endocrinology | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology | |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases | |
| 2080P0210X Pediatrics, Pediatric Nephrology | |
| 2080P0214X Pediatrics, Pediatric Pulmonology | |
| 363A00000X Physician Assistant | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2022-03-25 |