SHORELINE PEDIATRICS & ADOLESCENT MEDICINE, P.C. (NPI# 1538126941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538126941 |
| Entity Type | Organization |
| Organization Name | SHORELINE PEDIATRICS & ADOLESCENT MEDICINE, P.C. |
| Practice Address |
1110 Durham Rd Madison CT 06443-1858 |
| Practice Telephone | 2034213600 |
| Practice Fax Number | 2034213627 |
| Mailing Telephone | 2034213600 |
| Mailing Fax Number | 2034213627 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EDWARD H. GLEICH (PRESIDENT) |
| Authorized Official Telephone | 2034213600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
1110 DURHAM RD |
| City | MADISON |
| State | CT |
| Zip Code | 06443-1858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467432252 | Bruce G Freeman | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-18 |
| 1285258673 | Cristina Augusto | Student in an Organized Health Care Education/Training Program | 1110 Durham Rd, Madison, CT 06443-1858 | 2020-06-02 |
| 1346521929 | Hannah Elizabeth Thornton | Nurse Practitioner | 1110 Durham Rd, Madison, CT 06443-1858 | 2011-09-08 |
| 1932408291 | Kimberly Anne Palmieri | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2011-03-24 |
| 1023320983 | Amy G Golden | Nurse Practitioner | 1110 Durham Rd, Madison, CT 06443-1858 | 2010-07-08 |
| 1457331191 | Karen Y Goldberg | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| 1366422024 | Erin S. Springhorn | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| 1740260348 | Edward H. Gleich | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194127506 | Heather R. Clinton | Social Worker | 847 West Main Street, Suite 3, Branford, CT 06443 | 2014-09-17 |
| 1477973378 | Katrina Louise Furey | Psychiatry & Neurology | 147 Durham Rd Ste 12a-ne, Madison, CT 06443 | 2014-04-18 |
| 1972920114 | Elizabeth Laberee | Internal Medicine | 80 Devonshire Lane, Madison, CT 06443 | 2014-03-26 |
| 1588007314 | Avery Grauer | Psychiatry & Neurology | 175 Copse Road, Madison, CT 06443 | 2013-04-11 |
| 1295077790 | Gordon Seth Cohen | Pathology | 3 Silo Hill Road, Madison, CT 06443 | 2013-03-22 |
| 1073750493 | Darlene F. Talavera | Occupational Therapist | 22 Overshore Drive, Madison, CT 06443 | 2009-01-08 |
| 1013182518 | Susan Jean Isaac | Social Worker | 105 Winding Road, Unit 2, Madison, CT 06443 | 2008-04-25 |
| 1083893606 | Kornelia Keszler, Md, PC | Internal Medicine | 1-b Meigswood Ave, Madison, CT 06443 | 2007-10-31 |
| 1811181126 | Traci Marando | Nurse Practitioner | 20 Madrina Lane, Madison, CT 06443 | 2007-08-29 |
| 1790803419 | Linda L. Young | Social Worker | 2 Samson Rock Drive, Unit 2g, Madison, CT 06443 | 2007-03-27 |
| Find all providers in zip 06443 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1467432252 | Bruce G Freeman | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-18 |
| 1518278324 | Kids Time Pediatrics - East Cobb, LLC | Pediatrics | 696 Billups Ave, Madison, GA 30650-1439 | 2010-06-25 |
| 1184935223 | Kids Time Pediatrics - East Cobb LLC | Pediatrics | 696 Billups Ave, Madison, GA 30650-1439 | 2010-06-23 |
| 1205157054 | Kids Time Pediatrics - Alpharetta, LLC | Pediatrics | 696 Billups Ave, Madison, GA 30650-1439 | 2010-06-16 |
| 1376769794 | Paula J. Cody | Pediatrics | 2880 University Ave, Madison, WI 53705-3644 | 2007-04-17 |
| 1750402038 | Connecticut Pediatric Otolaryngology | Pediatrics | 230 Boston Post Rd, Madison, CT 06443-2225 | 2007-04-03 |
| 1457331191 | Karen Y Goldberg | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| 1366422024 | Erin S. Springhorn | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| 1740260348 | Edward H. Gleich | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780246306 | Pediatric Health Associates of Coneecticut, LLC | Pediatrics | 239 Silas Deane Hwy, Wethersfield, CT 06109-1730 | 2019-07-03 |
| 1073943668 | Pediatric Walk In Care LLC | Pediatrics | 141 B Hazard Avenue, Enfield, CT 06082-5412 | 2013-11-18 |
| 1225319445 | Enfield Pediatric Associates,p.c. | Pediatrics | 155 Hazard Ave Ste 14, Enfield, CT 06082-4586 | 2011-09-01 |
| 1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
| 1326166125 | Mary A. Simon | Pediatrics | 7 Melrose Dr, Farmington, CT 06032-0893 | 2007-03-27 |
| 1376678516 | Sydney Zane Spiesel | Pediatrics | 8 Lunar Dr, Woodbridge, CT 06525-2352 | 2007-02-21 |
| 1649314279 | Charles Ray Jones | Pediatrics | 111 Park St Ste F, New Haven, CT 06511-5412 | 2007-02-16 |
| 1427110469 | Radhika Malhotra | Pediatrics | 100 Bank St, Suite 307, Seymour, CT 06483-2806 | 2006-12-15 |
| 1386704682 | Andrews Adu Adade | Pediatrics | 18 Hillandale Ave, Stamford, CT 06902-2808 | 2006-12-11 |
| 1982706032 | John Gerald Pitegoff | Pediatrics | 1225 Silver St, Middletown, CT 06457-3920 | 2006-09-01 |
| Find all providers with the same taxonomy | ||||
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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.