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General NPI Number Information
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NPI Number | 1407917131
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Entity Type | Organization
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Legal Business Name | NEW CANAAN PEDIATRICS LLC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 173 EAST AVENUE
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City | NEW CANAAN
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State | CT
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Zip | 06840
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Country | US
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Telephone | 203-972-4250
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Fax | 203-801-2126
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Provider Business Mailing Address
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Address Line | 173 EAST AVENUE
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City | NEW CANAAN
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State | CT
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Zip | 06840
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Country | US
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Telephone | 203-972-4250
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Fax | 203-801-2126
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRISON J PIERCE
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Credential | MD
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Telephone | 203-972-4250
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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 | 027537
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License Number State | CT
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