# ENFIELD PEDIATRIC ASSOCIATES,P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225319445
- **Authorized official:** DR. ROSS WILLIAM PORTER M.D. (PRESIDENT)
- **Authorized official phone:** (860) 749-3169

## Contact information

- **Practice address:** 155 HAZARD AVE STE 14, ENFIELD, CT 06082-4586
- **Practice address phone:** (860) 749-3169
- **Mailing address:** 155 HAZARD AVE STE 14, ENFIELD, CT 06082-4586
- **Mailing address phone:** (860) 749-3169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 032642 | CT | Yes |

## Other

- **Enumeration date:** 09/01/2011
- **Last updated:** 09/01/2011