Healthcare Provider Details

I. General information

NPI: 1568104131
Provider Name (Legal Business Name): STRATFORD PEDIATRIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 MAIN ST
STRATFORD CT
06615-5843
US

IV. Provider business mailing address

2499 MAIN ST
STRATFORD CT
06615-5843
US

V. Phone/Fax

Practice location:
  • Phone: 203-386-9600
  • Fax: 203-386-9609
Mailing address:
  • Phone: 203-386-9600
  • Fax: 203-386-9609

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. EDUARDO FIGUEROA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 203-386-9600