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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | 038949 | CT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | 1389495 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497295174 | The Pediatric Care Center, LLC | Pediatrics | 6614 Augusta Hwy, Leesville, SC 29070-9213 | 2017-03-01 |
Street Address |
1301 FARMINGTON AVE |
City | BRISTOL |
State | CT |
Zip Code | 06010-4776 |
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 |
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 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 |
---|---|---|---|---|
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 |
Please comment or provide details below to improve the information on THE PEDIATRIC CARE CENTER, LLC.
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.