EAST AVENUE PEDIATRICS PC (NPI# 1093092165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093092165 |
| Entity Type | Organization |
| Organization Name | EAST AVENUE PEDIATRICS PC |
| Practice Address |
148 East Ave Suite 1l Norwalk CT 06851-5721 |
| Practice Telephone | 2038546993 |
| Practice Fax Number | 2038549227 |
| Mailing Telephone | 2038546993 |
| Mailing Fax Number | 2038549227 |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |
| Authorized Official Name | DR. LIBIA RUEDA-MATIK (PHYSICIAN) |
| Authorized Official Telephone | 2038546993 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 038173 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001381730 | 05 |
| Street Address |
148 EAST AVE SUITE 1L |
| City | NORWALK |
| State | CT |
| Zip Code | 06851-5721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992707616 | Richard A Stieglitz | Physical Therapist | 148 East Ave, Norwalk, CT 06851-5721 | 2005-08-12 |
| 1205201639 | Sheila Norko | Specialist/Technologist, Other | 148 East Ave, Suite 2g, Norwalk, CT 06851-5721 | 2015-12-10 |
| 1912381625 | Connecticut Orthopaedic Specialists, PC | Orthopaedic Surgery | 148 East Ave, Suite 2e, Norwalk, CT 06851-5721 | 2015-07-13 |
| 1942680616 | Kaitlyn Foley | Physician Assistant | 148 East Ave, Suite 2-i, Norwalk, CT 06851-5721 | 2015-06-08 |
| 1619365731 | Ct Recovery PC | Clinic/Center | 148 East Ave, Suite 1 D, Norwalk, CT 06851-5721 | 2014-12-23 |
| 1184029472 | Ct Recovery, PC | Plastic Surgery | 148 East Ave, Suite 1d, Norwalk, CT 06851-5721 | 2014-10-29 |
| 1710386933 | Diamond Braces of Norwalk Connecticut LLC | Dentist | 148 East Ave, Suite 3h, Norwalk, CT 06851-5721 | 2014-08-14 |
| 1891128575 | Dental Solutions | Dentist | 148 East Ave, 1c, Norwalk, CT 06851-5721 | 2013-08-16 |
| 1588916415 | Meghan Elizabeth Sadler | Physician Assistant | 148 East Ave, 2l, Norwalk, CT 06851-5721 | 2012-10-02 |
| 1619244043 | Amy Cimminello | Physician Assistant | 148 East Ave, Suite 1e, Norwalk, CT 06851-5721 | 2011-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144763434 | Cynthia Eliezer | Student in an Organized Health Care Education/Training Program | 120 East Ave 2nd Flr., Norwalk, CT 06851 | 2016-11-18 |
| 1356897672 | Be Balanced Naturopathic Care Center, LLC | Naturopath | 91 East Ave, Garden Level, Norwalk, CT 06851 | 2016-08-28 |
| 1861843559 | Valerie Andree Vincent | Student in an Organized Health Care Education/Training Program | 120 East Avenue-2nd Floor, Catholic Charities, Norwalk, CT 06851 | 2016-06-24 |
| 1417333758 | Laura Rebecca Nierenberg Fishman | Marriage & Family Therapist | 161 East Avenue, Suite 101, Norwalk, CT 06851 | 2015-08-10 |
| 1487085411 | Danielle Christine Boland | Social Worker | 206 Wolfpit Avenue, Norwalk, CT 06851 | 2013-12-02 |
| 1427485846 | Michelle Clement | Technician/Technologist | 650 Main Avenue, Norwalk, CT 06851 | 2013-09-30 |
| 1932447430 | Rebecca Roessler Velasquez | Social Worker | 225 W Rocks Rd, Norwalk, CT 06851 | 2013-01-18 |
| 1275809154 | Tiffany A. Mccarty | Social Worker | 166 East Ave Ste 204, Norwalk, CT 06851 | 2012-03-26 |
| 1356573547 | Cheree Louise Fenske | Clinical Neuropsychologist | 761 Main Ave Ste 104, Norwalk, CT 06851 | 2009-08-20 |
| 1083869572 | Carol Lynne Cooper | Obstetrics & Gynecology | 17 North Ave., Norwalk, CT 06851 | 2008-11-25 |
| Find all providers in zip 06851 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780810796 | Jennifer Maureen Varghese | Pediatrics | 12632 Bloomfield Ave, Apt#23, Norwalk, CA 90650-8313 | 2009-06-04 |
| 1063589349 | Minerva A Lobarbio | Pediatrics | 13710 Studebaker Road #100, Norwalk, CA 90650 | 2006-11-29 |
| 1669559951 | Patricia Jorquera | Pediatrics | 10 Mott Avenue, 4th Floor, Norwalk, CT 06850 | 2006-11-01 |
| 1548213929 | Sharlita M. Rodgers-simpkins | Pediatrics | 12360 Firestone Blvd, Norwalk, CA 90650-4324 | 2006-05-18 |
| 1700887932 | Glenn John Trippe | Pediatrics | 282 Benedict Ave, Suite B, Norwalk, OH 44857-2712 | 2005-08-10 |
| 1386642932 | Catherine T Ford | Pediatrics | 10 Mott Avenue 4th Floor, Norwalk, CT 06850 | 2005-07-08 |
| 1437696093 | Fisher-titus Pediatrics LLC | Pediatrics | 282 Benedict Ave, Suite B, Norwalk, OH 44857-2712 | 2017-01-20 |
| 1154784627 | Elizabeth Frances Marie Olds | Pediatrics | 282 Benedict Ave Ste B, Norwalk, OH 44857-2712 | 2016-04-01 |
| 1578981858 | Sean Butler | Pediatrics | 40 Cross St, Norwalk, CT 06851-4647 | 2014-04-02 |
| 1902240849 | Aniqa Anwar | Pediatrics | 40 Cross St, Norwalk, CT 06851-4647 | 2013-04-22 |
| Find all providers in NORWALK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.