PEDIATRIC & ADOLESCENT MEDICINE (NPI# 1265472583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265472583 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC & ADOLESCENT MEDICINE |
| Practice Address |
580 Burnside Ave Suite 3 East Hartford CT 06108-3579 |
| Practice Telephone | 8602827128 |
| Practice Fax Number | 8606461261 |
| Mailing Telephone | 8602827128 |
| Mailing Fax Number | 8606461261 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-12-16 |
| Authorized Official Name | SHAHEEN AHMED (OWNER) |
| Authorized Official Telephone | 8606435218 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004247252 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598887713 | Pediatric & Adolescent Medicine | Pediatrics | 5072 Reed Rd, Columbus, OH 43220-2514 | 2007-04-06 |
| 1821180506 | Pediatric & Adolescent Medicine | Pediatrics | 9235 Crown Crest Blvd, Suite 100, Parker, CO 80138-8880 | 2006-09-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | PEDIATRIC & ADOLESCENT MEDICINE OF FREDERICKSBURG INC. | 9456 Wooded Glen Ave, Burke, Virginia 22015 |
| Street Address |
580 BURNSIDE AVE SUITE 3 |
| City | EAST HARTFORD |
| State | CT |
| Zip Code | 06108-3579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245210764 | Sheikh Irfan Ahmed | Pediatrics | 580 Burnside Ave, Suite 4, East Hartford, CT 06108-3579 | 2006-01-19 |
| 1700329638 | Grisel Martinez Cruz | Dentist | 580 Burnside Ave, Suite 2, East Hartford, CT 06108-3579 | 2016-11-26 |
| 1396191797 | Anum Ahmed | Internal Medicine | 580 Burnside Ave, Ste 2, East Hartford, CT 06108-3579 | 2016-05-04 |
| 1851765986 | Woo Joong Kwon | Dentist | 580 Burnside Ave, East Hartford, CT 06108-3579 | 2015-12-01 |
| 1558761031 | Little Submarine Dental | Dentist | 580 Burnside Ave, East Hartford, CT 06108-3579 | 2014-09-03 |
| 1457772964 | Florence Olakojo | Nurse Practitioner | 580 Burnside Ave, Suite 4, East Hartford, CT 06108-3579 | 2013-12-31 |
| 1154757185 | Amazing Smile Family Dentistery | Dentist | 580 Burnside Ave, Suite# 6, East Hartford, CT 06108-3567 | 2013-09-23 |
| 1336573146 | Faisal Ijaz | Nurse Practitioner | 580 Burnside Ave, East Hartford, CT 06108-3579 | 2013-08-28 |
| 1710954961 | Connecticut Obgyn | Obstetrics & Gynecology | 580 Burnside Ave, Ste 4, East Hartford, CT 06108 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003437435 | Decent Homecare Services LLC | Homemaker | 527 Burnside Avenue, Suite 1, East Hartford, CT 06108 | 2020-04-27 |
| 1164055810 | First Choice Health Center Inc | Durable Medical Equipment & Medical Supplies | 110 Connecticut Blbd, East Hartford, CT 06108 | 2020-02-20 |
| 1457848731 | Heavenly Care LLC | Home Health | 35 Greene Terrace, East Hartford, CT 06108 | 2018-04-22 |
| 1750894275 | Thamara Vanessa Jonathas | Nurse Practitioner | 477 Connecticut Blvd Ste 119, East Hartford, CT 06108 | 2017-11-06 |
| 1851802474 | Empathic Care Counseling LLC | Counselor | 357 East Center Street, Manchester, CT 06108 | 2017-10-23 |
| 1235654427 | Kacey Megquier | Specialist/Technologist | 132 Arbutus Street, East Hartford, CT 06108 | 2017-08-08 |
| 1225559826 | First Choice Health Centers, Inc. | Clinic/Center | 809 Main Street, East Hartford, CT 06108 | 2017-07-05 |
| 1205361599 | Freda Osei-parker | Pharmacist | 16a Saint Regis Street, East Hartford, CT 06108 | 2017-04-25 |
| 1831648740 | Marcia Loving Care Home Care Agency | Home Health | 23 Bidwell Street, East Hartford, CT 06108 | 2016-10-04 |
| 1770932642 | First Choice Health Centers, Inc. | Clinic/Center | 92 Connecticut Boulevard, East Hartford, CT 06108 | 2016-06-10 |
| Find all providers in zip 06108 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598060907 | Charles Ekanem | Internal Medicine | 96 Silver Ln Apt B12, East Hartford, CT 06118-1007 | 2011-01-14 |
| 1568428449 | Edwin Amobi Njoku | Internal Medicine | 587 Burnside Ave, East Hartford, CT 06108-3537 | 2006-04-21 |
| 1144200122 | Sultan Quraishi | Internal Medicine | 677 Silver Ln, East Hartford, CT 06118-1257 | 2006-01-18 |
| 1083601256 | Anil K Vithala | Internal Medicine | 477 Connecticut Blvd, Suite 112, East Hartford, CT 06108-3268 | 2005-10-04 |
| 1992701932 | Michael B Fischer | Internal Medicine | 800 Connecticut Blvd, East Hartford, CT 06108-7303 | 2005-06-23 |
| 1396191797 | Anum Ahmed | Internal Medicine | 580 Burnside Ave, Ste 2, East Hartford, CT 06108-3579 | 2016-05-04 |
| 1285070607 | Niko Broodie-murray | Internal Medicine | 800 Connecticut Blvd, East Hartford, CT 06108-7303 | 2013-05-13 |
| 1003010745 | M. Hasan Yekta, M.d. P.C. | Internal Medicine | 27 Burnside Ave, East Hartford, CT 06108-3405 | 2007-06-14 |
| 1710188685 | Adarsh Jha | Internal Medicine | 893 Main St Ste 202, East Hartford, CT 06108-2293 | 2007-05-30 |
| 1780808949 | Alona Kantorovich | Internal Medicine | 94 Connecticut Blvd, East Hartford, CT 06108-3013 | 2007-04-12 |
| Find all providers in EAST HARTFORD | ||||
| City | EAST HARTFORD |
| Zip Code | 06108 |
Please comment or provide details below to improve the information on PEDIATRIC & ADOLESCENT MEDICINE.
| 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.