THE PEDIATRIC CARE CENTER, LLC


Address: 1301 Farmington Ave, Bristol, CT 06010-4776
Phone: 8605894501

THE PEDIATRIC CARE CENTER, LLC (NPI# 1902357163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902357163
Entity Type Organization
Organization Name THE PEDIATRIC CARE CENTER, LLC
Practice Address 1301 Farmington Ave
Bristol
CT 06010-4776
Practice Telephone 8605894501
Practice Fax Number 8605894502
Mailing Telephone 8605894501
Mailing Fax Number 8605894502
Enumeration Date 2016-10-21
Last Update Date 2020-10-07
Authorized Official Name SUSAN ADEYINKA (OWNER)
Authorized Official Telephone 8605894501
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics 038949 CT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CT 1389495 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1497295174 The Pediatric Care Center, LLC Pediatrics 6614 Augusta Hwy, Leesville, SC 29070-9213 2017-03-01

Office Location

Street Address 1301 FARMINGTON AVE
City BRISTOL
State CT
Zip Code 06010-4776

Providers in the same location

NPI Name Taxonomy Address Enumeration
1952309924 Lisa Menillo Pediatrics 1301 Farmington Ave, Bristol, CT 06010-4776 2005-07-13
1679736870 Mary Catherine Egan Mieczkowski Nurse Practitioner 1301 Farmington Ave, Bristol, CT 06010-4776 2008-07-08
1528120094 Susan Adeola Adeife Lee Pediatrics 1301 Farmington Ave, Bristol, CT 06010-4776 2006-12-14

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457991309 A New Hope Caregiving Alliance LLC Home Health 225 North Main Street - Suite 107, Bristol, CT 06010 2020-01-08
1154981777 Georgianna Sloate Lmft, LLC Marriage & Family Therapist 38 Kelley Street, Bristol, CT 06010 2019-06-17
1962062810 Ariel Morley Urology 15 Riverside Avenue, Bristol, CT 06010 2019-06-13
1013439488 Theresa Rose Manolitsis Student in an Organized Health Care Education/Training Program 170 Pondview Lane, Bristol, CT 06010 2017-07-07
1588103600 Elizabeth Anne Costello Pharmacist 747 Pine Street, Bristol, CT 06010 2017-02-22
1992157903 Aiman Riaz Internal Medicine 41 Brewster Rd # 5161, Bristol, CT 06010 2016-07-01
1346609955 Monika Magdalena Sullivan Nurse Practitioner 122 Maple Street, Bristol, CT 06010 2016-02-11
1346660776 Peter Bellezza Podiatrist 15 Riverside Ave, Bristol, CT 06010 2014-04-24
1487088001 Stephen Alexander Merwin Social Worker 32 Laird Drive, Bristol, CT 06010 2013-08-30
1215369574 In Kyung Lee Dentist 1192 Farmington Ave., Bristol, CT 06010 2013-08-08
Find all providers in zip 06010

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093760902 Internal Medicine and Pediatric Assoc of Bristol Pediatrics 350 Steeles Road, Bristol, TN 37620-9532 2006-05-23
1255381752 Thomas E Mitoraj Pediatrics 212 Midway Medical Park, Bristol, TN 37620-1664 2006-05-12
1114925195 Susan Glasser Pediatrics 43 Enterprise Dr, Bristol, CT 06010-7457 2005-07-13
1952309924 Lisa Menillo Pediatrics 1301 Farmington Ave, Bristol, CT 06010-4776 2005-07-13
1811994981 John Richard Hovious IIi Pediatrics 109 Meadow View Road, Suite 7, Bristol, TN 37620-1661 2005-07-05
1164765871 Cassie Brooks Hudson Pediatrics 240 Medical Park Blvd, Ste 3600, Bristol, TN 37620-7346 2013-04-01
1275841488 Youthcare Pediatrics Pediatrics 212 Midway Medical Park, Bristol, TN 37620-1664 2010-09-22
1649460874 Carla Elaine Bystricky Pediatrics 41 Brewster Rd, Bristol, CT 06010 2007-07-25
1821209578 Jessica D Hommel Pediatrics 320 Steeles Rd, Bristol, TN 37620-9532 2007-05-24
1043429806 Bristol Hospital Multi-specialty Group, Inc. Pediatrics 44 Brewster Road, Bristol, CT 06010 2007-05-21
Find all providers in BRISTOL

Competitor

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City BRISTOL
Zip Code 06010

Improve Information

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Dataset Information

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.

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