DR. MADHU MATHUR (NPI# 1235142100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235142100 |
| Entity Type | Individual |
| Full Name | DR. MADHU MATHUR |
| Credential | MD |
| Practice Address |
2777 Summer St Ste 604 Stamford CT 06905-4318 |
| Mailing Address |
104 River W Greenwich CT 06831-4100 |
| Practice Telephone | 2036148517 |
| Practice Fax Number | 2036148518 |
| Mailing Telephone | 2036148517 |
| Mailing Fax Number | 2036148518 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2016-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 039624 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BC/BS | 010039624CT01 | 01 |
| FOCUS | TIN | 01 | |
| CT | HEALTH NET | 2V4390 | 01 |
| CT | EMPIRE BC/BS | 507X21 | 01 |
| CT | OXFORD HEALTH PLAN | P2645508 | 01 |
| CT | FIRST HEALTH / CCN | 2079769 | 01 |
| POMCO | TIN | 01 | |
| CT | CONNECTICARE | 797586 | 01 |
| MULTIPLAN | TIN | 01 | |
| CT | UNITED HEALTHCARE | 2215002 | 01 |
| CT | CIGNA | 5129667 | 01 |
| CT | AETNA | 7916409 | 01 |
| PRIVATE HEALTHCARE SYSTEM | TIN | 01 | |
| WELLCARE/ FIRST CHOICE | TIN | 01 | |
| CONSUMER HEALTH NETWORK | TIN | 01 |
| Street Address |
2777 SUMMER ST STE 604 |
| City | STAMFORD |
| State | CT |
| Zip Code | 06905-4318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578980736 | Lifestyle Medicine Center LLC | Pediatrics | 2777 Summer St, Suite 604, Stamford, CT 06905-4318 | 2014-03-26 |
| 1609904960 | Sanders Martin Stein | Psychiatry & Neurology | 2777 Summer St, Suite 504b, Stamford, CT 06905-4318 | 2007-03-01 |
| 1750466074 | Ronald Craig Naso | Psychologist | 2777 Summer St, Suite 504b, Stamford, CT 06905-4318 | 2006-10-26 |
| 1609959782 | Larry M Rosenberg | Psychologist | 2777 Summer St, Suite 504b, Stamford, CT 06905-4318 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367272 | Smartport LLC | Non-emergency Medical Transport (VAN) | C/o Mollo, 1111 Summer St, Stamford, CT 06905 | 2020-05-13 |
| 1245889096 | Anna Diamantis | Counselor | 1200 High Ridge Road, 2nd Floor, Stamford, CT 06905 | 2019-09-04 |
| 1871150409 | Connecticut Anesthesia Associates LLC | Anesthesiology | 1177 High Ridge Road, Stamford, CT 06905 | 2019-05-20 |
| 1518447887 | Alexandra Petrov | Lactation Consultant, Non-RN | 42 Riverside Ave, Stamford, CT 06905 | 2018-08-16 |
| 1235640327 | A&s Chemists LLC | Pharmacy | 910 Summer Ave, Stamford, CT 06905 | 2017-10-17 |
| 1659805117 | Evolution Physical Therapy, LLC | Clinic/Center | 7 Reynolds Ave, Stamford, CT 06905 | 2017-04-11 |
| 1326587841 | Karen Poggi | Speech-Language Pathologist | 30 Buxton Farm Rd., Suite 230, Stamford, CT 06905 | 2017-02-16 |
| 1811434871 | Christina Skuburids, LLC | Point of Service | 2043 Bedford Street, Stamford, CT 06905 | 2017-01-27 |
| 1669833513 | Christian Alvarez | Occupational Therapist | 15 First St Unit 1, Stamford, CT 06905 | 2016-03-18 |
| 1932500915 | Emily Krol | Psychologist | 29 Yale Court, Stamford, CT 06905 | 2014-09-10 |
| Find all providers in zip 06905 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114328796 | Michal A Manaster | Pediatrics | 1515 Summer St., Suite 101, Stamford, CT 06905-5150 | 2014-09-15 |
| 1275819922 | Lynn Nayona Cunado | Pediatrics | 1515 Summer St Unit 101, Stamford, CT 06905-5150 | 2011-10-26 |
| 1457651283 | Lukas A Konandreas | Pediatrics | 660 Bedford St, Stamford, CT 06901 | 2010-10-27 |
| 1104133859 | Sarah Kirsten Bohrer | Pediatrics | 151 Rolling Wood Dr, Stamford, CT 06905-2329 | 2010-09-01 |
| 1619015690 | Yong-son Basta | Pediatrics | Stamford Hospital, 30 Shelburne Rd, Department of Pediatrics, Stamford, CT 06904-9317 | 2007-02-02 |
| 1346326410 | Andrew Stuart Hart | Pediatrics | 1275 Summer St Ste 301, Stamford, CT 06905-5315 | 2006-10-31 |
| 1881788198 | Haydee Liliana Bujman De Lancman | Pediatrics | 1515 Summer St, Ste 101, Stamford, CT 06905 | 2006-10-03 |
| 1134182710 | Abby L Siegel | Pediatrics | 1011 High Ridge Rd, #207, Stamford, CT 06905-1610 | 2006-04-06 |
| 1740275866 | Katherine Kelly Noble | Pediatrics | 2001 W Main St, Suite 132, Stamford, CT 06902-4501 | 2005-09-14 |
| 1063413854 | Timothy H Kenefick | Pediatrics | 126 Morgan St, Stamford, CT 06905-5431 | 2005-08-03 |
| Find all providers in STAMFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.