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General NPI Number Information
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NPI Number | 1417140922
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Entity Type | Organization
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Legal Business Name | HAMDEN PEDIATRICS
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 12/26/2012
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Provider Practice Location Address
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Address Line | 9 WASHINGTON AVE
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City | HAMDEN
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State | CT
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Zip | 06518-3267
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Country | US
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Telephone | 203-287-0552
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Fax | 203-287-1426
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Provider Business Mailing Address
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Address Line | 9 WASHINGTON AVE
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City | HAMDEN
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State | CT
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Zip | 06518-3267
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Country | US
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Telephone | 203-287-0552
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Fax | 203-287-1426
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. CHRISTOPHER RICHARD CANNY
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Credential | MD
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Telephone | 203-287-0552
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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 | 020653
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License Number State | CT
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