Organization Name: | PEDIATRICS PLUS PC |
NPI Number: | 1013287218 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELSA L. STONE (PRESIDENT) |
Mailing Address: | 13 Peck St North Haven |
State: | CT US |
Postal Code: | 064732308 |
Phone Number: | 2032394627 |
Fax Number: | 2032348533 |
NPI Enumeration Date: | 01/04/2012 |
NPI Last Update Date: | 01/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 7148307-000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |