NEW HAVEN PEDIATRIC & ADOLESCENT MEDICAL SERV (NPI# 1962680934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962680934 |
| Entity Type | Organization |
| Organization Name | NEW HAVEN PEDIATRIC & ADOLESCENT MEDICAL SERV |
| Other Organization Name | TAMIKO V JACKSON MD |
| Practice Address |
1423 Chapel St Unit 2b New Haven CT 06511 |
| Practice Telephone | 2037520706 |
| Practice Fax Number | 2037720387 |
| Mailing Telephone | 2037520706 |
| Mailing Fax Number | 2037720387 |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-02-01 |
| Authorized Official Name | ANGEL JACKSON (OFFICE MANAGER) |
| Authorized Official Telephone | 2039063854 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
0002815 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208000000X | Pediatrics | 0136872 | CT | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Tamiko V Jackson MD | Doing Business As Name - Organization |
| Street Address |
1423 CHAPEL ST UNIT 2B |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962491803 | Robert R Sorrentino | Dentist | 1423 Chapel St, New Haven, CT 06511-4411 | 2005-10-13 |
| 1952755563 | Nia Health Group LLC | Naturopath | 1423 Chapel St, New Haven, CT 06511-4411 | 2016-04-20 |
| 1386000941 | Primary Care and Walk In LLC | Internal Medicine | 1423 Chapel St, 1 B, New Haven, CT 06511-4411 | 2016-01-12 |
| 1780089698 | Elisabeth Makubika | Nurse Practitioner | 1423 Chapel St, 1-a, New Haven, CT 06511-4411 | 2014-11-04 |
| 1992109656 | New Haven Implant and Oral Surgery, LLC | Dentist | 1423 Chapel St, Unit 3c, New Haven, CT 06511-4411 | 2014-10-09 |
| 1174925606 | Peoples Home Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 1423 Chapel St, 3b, New Haven, CT 06511-4411 | 2014-09-16 |
| 1023419587 | Parvez Baig Dmd Corporation | Dentist | 1423 Chapel St, Suite 3a, New Haven, CT 06511-4411 | 2014-09-15 |
| 1265862098 | Jillian Sacco | Nurse Anesthetist, Certified Registered | 1423 Chapel St, New Haven, CT 06511-4411 | 2013-11-14 |
| 1407280647 | Jillian Nicole Buturla | Nurse Practitioner | 1423 Chapel St, 2b, New Haven, CT 06511-4411 | 2013-08-23 |
| 1528310521 | Michael Liam Flaherty | Nurse Anesthetist, Certified Registered | 1423 Chapel St, New Haven, CT 06511-4411 | 2012-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330571 | Allison Elizabeth Pratt | Occupational Therapist | 625 Whitney Ave, Apt 5, New Haeven, CT 06511 | 2020-09-11 |
| 1881213346 | Sarah Bleicher | Registered Nurse | Yale Health, 55 Lock St, New Haven, CT 06511 | 2020-04-14 |
| 1083268395 | Danielle Lee Mcpherson | Pharmacist | Yale New Haven Hospital 55 Park Street, New Haven, CT 06511 | 2019-07-25 |
| 1528533866 | Alexia Levin | Social Worker | 98/100 York St, New Haven, CT 06511 | 2018-10-12 |
| 1861970097 | Orthocare Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1450 Chapel St Ste Sg15, New Haven, CT 06511 | 2018-07-31 |
| 1609352418 | Susannah Frew | Social Worker | 2 Eld Street, Apt 6, New Haven, CT 06511 | 2018-07-15 |
| 1851881965 | Empowerment Counseling Services, LLC | Counselor | 427 Dixwell Ave, New Haven, CT 06511 | 2018-05-14 |
| 1487173951 | Karine Giasson-gariepy | Student in an Organized Health Care Education/Training Program | Yale University Department of Psychiatry, 300 George Street, Suite 901, New Haven, Ct 06511, New Haven, CT 06511 | 2017-09-15 |
| 1568980696 | Anna Reutenauer | Dentist | 123 York St Ste 4l, New Haven, CT 06511 | 2017-09-08 |
| 1083134753 | Darin Dolezal | Student in an Organized Health Care Education/Training Program | 200 South Frontage Road, Ep2 2nd Floor - 612, Dept of Pathology, New Haven, CT 06511 | 2017-06-23 |
| Find all providers in zip 06511 | ||||
| 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 |
|---|---|---|---|---|
| 1225322456 | Matthew Drago | Pediatrics | 1 Park St # Wp4, New Haven, CT 06504-8901 | 2011-06-06 |
| 1497082648 | Jason Henry Greenberg | Pediatrics | 15 W Rock Ave, New Haven, CT 06515-2218 | 2009-11-09 |
| 1841428406 | Angela M Montgomery | Pediatrics | 20 York St # Wp493, Yale-new Haven Hospital, New Haven, CT 06510-3220 | 2009-06-22 |
| 1538396353 | Erin A Nozetz | Pediatrics | 20 York St # T209, Yale New Haven Hospital, New Haven, CT 06510-3220 | 2009-06-18 |
| 1891933727 | Lawrence Tse Siew | Pediatrics | 100 York St Ste 1f, New Haven, CT 06511-5664 | 2009-01-30 |
| 1750548848 | Dean Yimlamai | Pediatrics | 333 Cedar St # 4093, New Haven, CT 06510-3206 | 2008-05-18 |
| 1134394323 | Nicole Marie Brown | Pediatrics | 333 Cedar Street Shm Ie-61, New Haven, CT 06520 | 2008-04-28 |
| 1376720961 | Adam Kenneth Berkwitt | Pediatrics | 20 York St, T209, Yale New Haven Hospital, New Haven, CT 06510 | 2008-01-25 |
| 1780885871 | Lindsay Callahan Johnston | Pediatrics | 333 Cedar St, Wp 493 Box 208064, Yale University, Dept. of Pediatrics, Neonatology, New Haven, CT 06520-8064 | 2007-05-29 |
| 1245328335 | Nancy Monestime-williams | Pediatrics | 646 Quinnipiac Ave, New Haven, CT 06513-4003 | 2006-10-11 |
| Find all providers in NEW HAVEN | ||||
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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.