Individual
STEPHEN J MADDOX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
160 ROBBINS ST, WATERBURY, CT 06708-2652
(203) 755-2999
(203) 755-6782
Mailing address
160 ROBBINS ST, WATERBURY, CT 06708-2652
(203) 755-2999
(203) 755-6782
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
045563
CT
208000000X
Pediatrics Physician
230823
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008016138
—
CT
01
—
045563
PHYSICIAN LICENSE
CT
Enumeration date
02/27/2006
Last updated
02/11/2016
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