Modern Era Pediatric Practice
Pediatric Adolescent Medicine
Modern Era Pediatric Practice is a Bridgeport, Connecticut based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
3715 Main St, Suite 403, Bridgeport, Connecticut - 06606-3618. They can be contacted on phone at
203-371-4800 and fax number 203-371-4900.
NPI number (Unique professional ID) for Modern Era Pediatric Practice is
1194817460 which was assigned by NPPES on 28 Sep, 2006 and it was last updated on 09 Nov, 2012.
Modern Era Pediatric Practice 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:
Modern Era Pediatric Practice basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Modern Era Pediatric Practice |
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Business Address:
Modern Era Pediatric Practice 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 : | 3715 Main St, Suite 403
Bridgeport, CT, 06606-3618
United States |
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| Phone Number : | 203-371-4800 |
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| Fax Number : | 203-371-4900 |
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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 : | 1194817460 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 28 Sep, 2006 |
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| Last Updated On : | 09 Nov, 2012 |
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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 : | Anselmchibuike Anyoha |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | MEDICAL DIRECTOR |
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| Phone Number : | 203-371-4800 |
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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 Modern Era Pediatric Practice are as mentioned. Primary taxonomy code for Modern Era Pediatric Practice is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Modern Era Pediatric Practice such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 001352799 | 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 : | 3715 Main St, Suite 403
Bridgeport, CT, 06606-3618
United States |
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| Phone Number : | 203-371-4800 |
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| Fax Number : | 203-371-4900 |
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Business Location:
Patients can refer following map for directions to
Modern Era Pediatric Practice practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.