Individual
DR. MARGARET KIYO IKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
374 GRAND AVE, NEW HAVEN, CT 06513-3733
(203) 777-7411
(203) 777-6508
Mailing address
11 FLYING POINT RD, BRANFORD, CT 06405-5703
(203) 488-2296
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
028111
CT
2080P0208X
Pediatric Infectious Diseases Physician
028111
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001281112
—
CT
01
—
028111
MEDICAL LICENSE
CT
01
—
17724
CONTROLLED SUBSTANCE
CT
01
—
38502
AMERICAN BOARD PEDIATRICS
CT
Enumeration date
10/02/2006
Last updated
03/07/2023
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