Healthcare Provider Details

I. General information

NPI: 1750234043
Provider Name (Legal Business Name): CENTRAL CONNECTICUT PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 WORTHINGTON RDG
BERLIN CT
06037-3233
US

IV. Provider business mailing address

742 WORTHINGTON RDG
BERLIN CT
06037-3233
US

V. Phone/Fax

Practice location:
  • Phone: 860-829-7337
  • Fax: 860-829-2295
Mailing address:
  • Phone: 860-829-7337
  • Fax: 860-829-2295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BRYAN ROGER HOLLAND
Title or Position: MANAGING PHYSICIAN
Credential: MD
Phone: 860-385-0609