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General NPI Number Information
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NPI Number | 1285709063
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Entity Type | Organization
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Legal Business Name | THE CHILDREN'S MEDICAL GROUP OF GREENWICH, PC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 42 SHERWOOD PLACE THE CHILDREN'S MEDICAL GROUP
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City | GREENWICH
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State | CT
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Zip | 06830-5638
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Country | US
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Telephone | 203-661-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 42 SHERWOOD PLACE THE CHILDREN'S MEDICAL GROUP
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City | GREENWICH
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State | CT
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Zip | 06830-1622
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Country | US
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Telephone | 203-661-2440
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID A HEDRICK
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Credential | M.D.
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Telephone | 203-661-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 022046
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License Number State | CT
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