Healthcare Provider Details

I. General information

NPI: 1427275635
Provider Name (Legal Business Name): CHILDREN'S MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WESTFIELD AVE
ANSONIA CT
06401-1163
US

IV. Provider business mailing address

20 WESTFIELD AVE
ANSONIA CT
06401-1163
US

V. Phone/Fax

Practice location:
  • Phone: 203-734-1644
  • Fax: 203-734-9222
Mailing address:
  • Phone: 203-734-1644
  • Fax: 203-734-9222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JANIS BARRETT
Title or Position: OFFICE MANAGER
Credential:
Phone: 203-734-1644