Gold Star Pediatrics Llc

NPI 1033311915 - Pediatrics - 208000000X

NPI Details
NPI 1033311915
Enumeration Date 06/04/2007
Last Updated 12/29/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MICHAEL MICHAEL
Position OWNER
Phone (860) 449-8882
Fax (860) 449-9195
Practice Location
495 GOLD STAR HWY
STE 495
GROTON CT, 06340-6228, US
Phone (860) 449-8882
Fax (860) 449-9195
Business Location
495 GOLD STAR HWY
STE 120
GROTON CT, 06340-6228, US
Phone (860) 449-8882
Fax (860) 449-9195
Toxanomy
Taxonomy Code 208000000X
License State Connecticut
License Number 22070
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According to our database, Gold Star Pediatrics Llc NPI is 1033311915, taxonomy code is 208000000X and license number is 22070, license state is located at Connecticut. Gold Star Pediatrics Llc physically located at 495 Gold Star Hwy, Groton CT, 06340-6228. NPI Number 1033115704 has the healthcare provider type.

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1033311915 NPI number is provided on an as is basis without warranty of any kind. 1033311915 is maintained by the National Plan & Provider Enumeration System. The contents of Gold Star Pediatrics Llc are for informational purposes only.