Organization
MANCHESTER PEDIATRIC ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SWATHANTHRA KUMAR MELEKOTE MD (OWNER)
(860) 647-8282
Entity
Organization
Contact information
Practice address
2701 TAMARACK AVE, SOUTH WINDSOR, CT 06074-5561
(860) 647-8282
(860) 647-8399
Mailing address
2701 TAMARACK AVE, SOUTH WINDSOR, CT 06074-5561
(860) 647-8282
(860) 647-8399
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
043564
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629061965
—
CT
Enumeration date
11/09/2010
Last updated
03/17/2018
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