Organization Name: | BRANFORD NORTH BRANFORD PEDIATRICS,PC |
NPI Number: | 1619186574 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA A. WALDMAN (PRESIDENT) |
Mailing Address: | 999 Foxon Rd North Branford |
State: | CT US |
Postal Code: | 064711287 |
Phone Number: | 2034847334 |
Fax Number: | 2034847301 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 05/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |