| NPI | 1053612911 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2010-11-09 |
| Last Updated | 2018-03-17 |
| Authorized Official | Swathanthra Melekote Owner Phone: 8606478282 |
| Mailing Address | 2701 Tamarack Ave South Windsor, CT 06074-5561 United States Phone: (860) 647-8282 | Fax: (860) 647-8399 📍 View Map |
| Primary Practice Address | 2701 Tamarack Ave South Windsor, CT 06074-5561 United States Phone: (860) 647-8282 | Fax: (860) 647-8399 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | CT | 1629061965 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 208000000X – Pediatrics | CT | 043564 |
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About NPI 1053612911
Manchester Pediatric Associates Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1053612911. The primary specialty listed is Pediatrics. The organization is located in South Windsor, CT. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2010-11-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1053612911?
NPI 1053612911 belongs to Manchester Pediatric Associates Llc, a Pediatrics in South Windsor, CT. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1053612911 active?
The current status of NPI 1053612911 in the NPPES registry is Active. The record was last updated on 2018-03-17.
What specialty is NPI 1053612911?
NPI 1053612911 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1053612911?
You can verify NPI 1053612911 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1053612911?
The primary practice address on file for NPI 1053612911 is 2701 Tamarack Ave, South Windsor, CT 06074-5561. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1053612911 issued?
NPI 1053612911 was first issued (enumerated) on 2010-11-09. The NPPES record was last updated on 2018-03-17.
Practice Location Map
Manchester Pediatric Associates Llc is located at 2701 Tamarack Ave, South Windsor, CT. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Manchester Pediatric Associates Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1053612911. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pediatrics | 043564 | CT |