Kids Station Pediatrics
Pediatric Adolescent Medicine
Kids Station Pediatrics is a Manchester, Connecticut based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
191 Main St, Manchester, Connecticut - 06042-3556. They can be contacted on phone at
860-643-7973 and fax number 860-643-0175.
NPI number (Unique professional ID) for Kids Station Pediatrics is
1417153677 which was assigned by NPPES on 25 Jun, 2007 and it was last updated on 08 Oct, 2013.
Kids Station Pediatrics 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.
Complete Profile:
Kids Station Pediatrics basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Kids Station Pediatrics |
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Business Address:
Kids Station Pediatrics address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 191 Main St
Manchester, CT, 06042-3556
United States |
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| Phone Number : | 860-643-7973 |
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| Fax Number : | 860-643-0175 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1417153677 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 25 Jun, 2007 |
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| Last Updated On : | 08 Oct, 2013 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Donaldfrancis Mordavsky |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | CEO |
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| Phone Number : | 860-643-7973 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kids Station Pediatrics are as mentioned. Primary taxonomy code for Kids Station Pediatrics is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 363LP0200X | Nurse Practitioner Pediatrics | No | | CT |
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Kids Station Pediatrics such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 004132651 | MEDICAID | CT | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 191 Main St
Manchester, CT, 06042-3556
United States |
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| Phone Number : | 860-643-7973 |
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| Fax Number : | 860-643-0175 |
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Business Location:
Patients can refer following map for directions to
Kids Station Pediatrics practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.