Organization
EAST AVENUE PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIBIA RUEDA-MATIK (PHYSICIAN)
(203) 854-6993
Entity
Organization
Contact information
Practice address
148 EAST AVE, SUITE 1L, NORWALK, CT 06851-5721
(203) 854-6993
(203) 854-9227
Mailing address
148 EAST AVE, SUITE 1L, NORWALK, CT 06851-5721
(203) 854-6993
(203) 854-9227
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038173
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001381730
—
CT
Enumeration date
11/03/2011
Last updated
11/03/2011
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