Kids Station Pediatrics
LBN: Kids Station Pediatrics
Kids Station Pediatrics is an health care organization with primary practice located at 191 Main St , Manchester CT 06042-3556. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Allopathic & Osteopathic Physicians / Adolescent Medicine is the primary health care specialty.
Kids Station Pediatrics can be contacted via phone (860) 643-7973, or through Mordavsky, Donald Francis via phone (860) 643-7973.
Contact Information
Primary practice address
191 Main St
Manchester CT 06042-3556
Phone: (860) 643-7973
Fax: (860) 643-0175
Website:
Authorized official contact:
Name: Mordavsky, Donald Francis Doctor of Medicine (MD)
Phone: (860) 643-7973
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | Connecticut |
Profile Details
| NPI number | 1417153677 |
|---|---|
| LBN Legal business name | Kids Station Pediatrics |
| DBA Doing business as | |
| Authorized official | Mordavsky, Donald Francis Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 25th, 2007 |
| Last updated | Oct 8th, 2013 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417153677 | NPPES |
| Connecticut | MEDICAID | 004132651 |
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