Healthcare Provider Details

I. General information

NPI: 1205844115
Provider Name (Legal Business Name): NEW ENGLAND PEDIATRICS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 CHERRY ST
NEW CANAAN CT
06840-4820
US

IV. Provider business mailing address

183 CHERRY ST
NEW CANAAN CT
06840-4820
US

V. Phone/Fax

Practice location:
  • Phone: 203-472-5232
  • Fax: 203-972-5234
Mailing address:
  • Phone: 203-972-5232
  • Fax: 203-972-5234

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. ROSEMARY ELLEN KLENK
Title or Position: PARTNER
Credential: MD
Phone: 203-972-5232