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Organization

RIVER VALLEY PEDIATRICS AND ADOLESCENT MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELIZABETH MADELINE BIRD MD (MEDICAL DIRECTOR)
(860) 532-0525
Entity
Organization

Contact information

Practice address
20 WATER ST, CHESTER, CT 06412
(401) 490-1289
Mailing address
2 DEEP HOLLOW RD, CHESTER, CT 06412-1112
(860) 532-0525
(860) 483-5134

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
53136
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008080251
CT
Enumeration date
05/21/2018
Last updated
08/17/2018
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