Organization
PM PEDIATRICS OF CONNECTICUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE MARIE LOPEZ (MANAGER CREDENTIALING/ENROLLMENT)
(516) 207-7936
Entity
Organization
Contact information
Practice address
1459 NEW BRITAIN AVE, WEST HARTFORD, CT 06110-1659
(860) 232-5437
(860) 232-2110
Mailing address
1 HOLLOW LN STE 301, NEW HYDE PARK, NY 11042-1215
(516) 869-0650
(516) 673-9408
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/28/2017
Last updated
01/21/2025
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