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Organization
CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC.
Active
Organization
CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI ALLEN-DUNN (DIRECTOR, MEDICAL STAFF & CREDENTIA)
(860) 837-5561
Entity
Organization
Contact information
Practice address
131 NEW LONDON TPKE STE 200, GLASTONBURY, CT 06033-2246
(860) 837-9628
Mailing address
10 COLUMBUS BLVD FL 4, HARTFORD, CT 06106-1976
(186) 083-7561
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
NULL
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
—
NULL
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
NULL
2080P0205X
Pediatric Endocrinology Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
NULL
2080P0206X
Pediatric Gastroenterology Physician
—
—
2080P0207X
Pediatric Hematology & Oncology Physician
—
NULL
2080P0207X
Pediatric Hematology & Oncology Physician
—
—
2080P0208X
Pediatric Infectious Diseases Physician
—
NULL
2080P0208X
Pediatric Infectious Diseases Physician
—
—
2080P0210X
Pediatric Nephrology Physician
—
NULL
2080P0210X
Pediatric Nephrology Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
—
NULL
2080P0214X
Pediatric Pulmonology Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
02/25/2021
Last updated
12/05/2023
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