MARYBETH PYTLIK ELLISON (NPI# 1609034438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609034438 |
| Entity Type | Individual |
| Full Name | MARYBETH PYTLIK ELLISON |
| Other Name | MARYBETH PYTLIK ELLISON |
| Credential | MD |
| Practice Address |
Sunflower Developmental Pediatrics 11 Wildwood Medical Center Essex CT 06426 |
| Mailing Address |
16 Surrey Dr Durham CT 06422-3312 |
| Practice Telephone | 8603659300 |
| Practice Fax Number | 8603659300 |
| Mailing Telephone | 8602622462 |
| Mailing Fax Number | 8603659300 |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2018-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 033211 | CT | Allopathic & Osteopathic Physicians |
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
033211 | CT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Yale Department of Pediatrics, 15 York St, New Haven, CT 065103221 | 2037854081 | 2037377635 |
| Street Address |
SUNFLOWER DEVELOPMENTAL PEDIATRICS 11 WILDWOOD MEDICAL CENTER |
| City | ESSEX |
| State | CT |
| Zip Code | 06426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123867 | Art Therapy & Creative Counseling | Counselor | 80 Plains Rd Unit 1, Essex, CT 06426 | 2017-06-05 |
| 1487085593 | Catherine Mary Demers | Nurse Practitioner | 10 Wildwood Medical Center, Essex, CT 06426 | 2013-11-29 |
| 1346515723 | Anne Peterson | Counselor | 80 Plains Rd, Essex, CT 06426 | 2012-03-19 |
| 1477851731 | Diana Leigh Amara | Counselor | 80 Plains Road, Essex, CT 06426 | 2011-03-09 |
| 1780749747 | Dana Lyn Martin | Counselor | 190 Westbrook Road, Essex Child Guidance Clinic, Essex, CT 06426 | 2006-12-27 |
| 1881768836 | Jason Christopher Andrade | Counselor | 190 Westbrock Rd, Essex, CT 06426 | 2006-11-20 |
| 1386735546 | Robert D Dwyer | Urology | 6 Wildwood Medical Center, Essex, CT 06426 | 2006-09-27 |
| 1154421071 | Sharon D Mallon | Psychologist | 251 Westbrook Rd, Essex, CT 06426 | 2006-09-22 |
| 1043319510 | Brian David Fay | Social Worker | 251 Westbrook Road, Essex, CT 06426 | 2006-09-21 |
| 1104831460 | Christina Fultz Rickenback | Nurse Practitioner | One Wildwood Medical Center, Essex, CT 06426 | 2006-07-29 |
| Find all providers in zip 06426 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396906384 | Ana C Garnecho | Pediatrics | 761 Main Ave Ste 203, Norwalk, CT 06851-1080 | 2008-06-23 |
| 1306103593 | Oana De Vinck | Pediatrics | 333 Cedar St, New Haven, CT 06510-3206 | 2012-04-12 |
| 1497907695 | Jan Harold De La Cruz Sia | Pediatrics | 333 Cedar Street, New Haven, CT 06520 | 2008-10-21 |
| 1679737191 | Abha Rani Gupta | Pediatrics | 230 S Frontage Rd, Child Study Center, New Haven, CT 06519-1124 | 2008-07-14 |
| 1811170731 | Darcy Ilene Lowell | Pediatrics | 267 Grant St, Bridgeport, CT 06610-2805 | 2007-12-13 |
| 1972668143 | Paul H. Dworkin | Pediatrics | 282 Washington St, Suite 4e, Hartford, CT 06106-3322 | 2006-12-27 |
| 1902871098 | John Pelegano | Pediatrics | 2150 Corbin Ave, New Britain, CT 06053-2266 | 2006-02-22 |
| 1972578409 | Ann Milanese | Pediatrics | 282 Washington St, Hartford, CT 06106-3322 | 2006-02-20 |
| 1477534089 | Hospital for Special Care | Pediatrics | 2150 Corbin Ave, New Britain, CT 06053-2266 | 2005-11-10 |
| 1376541383 | Thyde Dumont-mathieu | Pediatrics | 1000 Asylum Ave, Suite 1026, Hartford, CT 06105-1770 | 2005-07-13 |
| Find all providers with the same taxonomy | ||||
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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.