PEDICORP, PC


Address: 345 N Main St, Suite 248, West Hartford, CT 06117-2515
Phone: 8602318453

PEDICORP, PC (NPI# 1952581928) 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) 1952581928
Entity Type Organization
Organization Name PEDICORP, PC
Practice Address 345 N Main St
Suite 248
West Hartford
CT 06117-2515
Practice Telephone 8602318453
Practice Fax Number 8605234061
Mailing Telephone 8602318453
Mailing Fax Number 8605234061
Enumeration Date 2007-11-07
Last Update Date 2007-11-07
Authorized Official Name MS. ELLEN GUERTIN (PRACTICE MANAGER)
Authorized Official Telephone 8602318453
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080A0000X Pediatrics
Specialization: Adolescent Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 345 N MAIN ST
SUITE 248
City WEST HARTFORD
State CT
Zip Code 06117-2515

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710987789 Moshe Laub Chiropractor 345 N Main St, Suite 322, West Hartford, CT 06117-2515 2005-07-29
1699290312 Amanda Zapka Silverman Nurse Practitioner 345 N Main St, West Hartford, CT 06117-2515 2017-08-03
1003274556 Erin Hannan Nurse Practitioner 345 N Main St, Suite 248, West Hartford, CT 06117-2515 2016-01-28
1073981841 Kelly Ann Riggieri Nurse Practitioner 345 N Main St, Suite 245, West Hartford, CT 06117-2515 2015-09-09
1679989792 Konstantia E Papapateras Dietitian, Registered 345 N Main St, West Hartford, CT 06117-2515 2014-07-09
1205249604 Gina Payne Marriage & Family Therapist 345 N Main St, Suite 306, West Hartford, CT 06117-2515 2014-06-04
1174951636 Eliane Provencher Nutritionist 345 N Main St, Neiha, West Hartford, CT 06117-2515 2013-10-21
1447512017 Rachel Billstrom Nelson Obstetrics & Gynecology 345 N Main St, Suite 201, West Hartford, CT 06117-2515 2012-06-11
1992073928 The Next Right Thing Counselor 345 N Main St, Suite 306, West Hartford, CT 06117-2515 2011-12-05
1083992481 Trinh Tu Tran Physician Assistant 345 N Main St, Suite 200, West Hartford, CT 06117-2515 2011-08-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154817237 Mmp Therapy and Consulting Community/Behavioral Health 2475 Albany Avenue, West Hartford, CT 06117 2018-07-02
1669856555 Noah Joseph Bluestone Psychologist 68 Soutth Main St, Suite 202, West Hartford, CT 06117 2015-07-10
1487040747 Nancy Cabelus Registered Nurse 1678 Asylum Ave. Room 317, University of St. Joseph, West Hartford, CT 06117 2015-04-13
1124384276 Louis Brown Thoracic Surgery (Cardiothoracic Vascular Surgery) 164 Orchard Rd, West Hartford, CT 06117 2012-04-03
1720282882 Ruth Kahn Psychologist 54 Mountain Brook Road, West Hartford, CT 06117 2007-06-13
1437370426 Dana Orthodontics PC Dentist 2446 Albany Avenue, West Hartford, CT 06117 2007-05-01
1972723146 Michelle Payson Occupational Therapist One Abrahms Boulevard, West Hartford, CT 06117 2007-04-27
1457579583 Kathy A Mccloskey Psychologist 200 Bloomfield Avenue, University of Hartford, West Hartford, CT 06117 2007-04-23
1427181585 Nancy L White Naturopath 10 Crossroads Plaza, West Hartford, CT 06117 2007-03-14
1689743452 August C Olivar Obstetrics & Gynecology 2437 Albany Avenue, Suite 202, West Hartford, CT 06117 2006-11-07
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Taxonomy Information

Taxonomy Code 2080A0000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Adolescent Medicine

Taxonomy Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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/certification
- 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
1942319157 Margaret M O'neill Pediatrics 970 Farmington Ave Ste 201, West Hartford, CT 06107-2134 2006-08-30
1154399202 Allyson N Duffy Pediatrics 345 North Main St, Ste 248, West Hartford, CT 06117 2006-03-14
1396716353 Della M Corcoran Pediatrics 970 Farmington Ave, Ste 201, West Hartford, CT 06107 2006-01-30
1760453724 Leo Joseph Distefano IIi Pediatrics 970 Farmington Avenue, Suite 201, West Hartford, CT 06107 2006-01-30
1265400329 Tilak C Gooneratne Pediatrics 345 N Main St, Ste 248, West Hartford, CT 06117 2006-03-14
1710954607 Parvin Fadakar Pediatrics 345 North Main St, Ste 248, West Hartford, CT 06117 2006-03-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1780246306 Pediatric Health Associates of Coneecticut, LLC Pediatrics 239 Silas Deane Hwy, Wethersfield, CT 06109-1730 2019-07-03
1073943668 Pediatric Walk In Care LLC Pediatrics 141 B Hazard Avenue, Enfield, CT 06082-5412 2013-11-18
1225319445 Enfield Pediatric Associates,p.c. Pediatrics 155 Hazard Ave Ste 14, Enfield, CT 06082-4586 2011-09-01
1962686824 Kimberly Ju Kim Pediatrics 820 C Prospect Hill Road, Windsor, CT 06095 2007-12-27
1326166125 Mary A. Simon Pediatrics 7 Melrose Dr, Farmington, CT 06032-0893 2007-03-27
1376678516 Sydney Zane Spiesel Pediatrics 8 Lunar Dr, Woodbridge, CT 06525-2352 2007-02-21
1649314279 Charles Ray Jones Pediatrics 111 Park St Ste F, New Haven, CT 06511-5412 2007-02-16
1427110469 Radhika Malhotra Pediatrics 100 Bank St, Suite 307, Seymour, CT 06483-2806 2006-12-15
1386704682 Andrews Adu Adade Pediatrics 18 Hillandale Ave, Stamford, CT 06902-2808 2006-12-11
1982706032 John Gerald Pitegoff Pediatrics 1225 Silver St, Middletown, CT 06457-3920 2006-09-01
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Competitor

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City WEST HARTFORD
Zip Code 06117

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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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