Organization
ROSS PORTER
Active
Other names
Enfield Pediatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSS W. PORTER MD (OWNER DOCTOR)
(860) 749-3169
Entity
Organization
Contact information
Practice address
141B HAZARD AVENUE, ENFIELD, CT 06082-4521
(860) 749-3169
(860) 749-2670
Mailing address
141B HAZARD AVENUE, ENFIELD, CT 06082-4521
(860) 749-3169
(860) 749-2670
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
032642
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004224630
—
CT
Enumeration date
08/29/2007
Last updated
06/30/2008
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