MS. EARLENE JANE PECKHAM (NPI# 1619901535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619901535 |
| Entity Type | Individual |
| Full Name | MS. EARLENE JANE PECKHAM |
| Credential | APRN,CPNP,MSN |
| Practice Address |
191 Fountain St New Haven CT 06515-1901 |
| Mailing Address |
658 Chestnut Ridge Rd Orange CT 06477-2029 |
| Practice Telephone | 2039466606 |
| Practice Fax Number | 2039466637 |
| Mailing Telephone | 2033879967 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
000425 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
191 FOUNTAIN ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06515-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699156356 | Erica Reshard | Counselor | 79 Long Hill Ter, New Haven, CT 06515 | 2015-06-17 |
| 1295136075 | Stephanie Silvestri | Social Worker | 63 Fountain Street, New Haven, CT 06515 | 2014-09-11 |
| 1013261080 | Kunal Kanani | Dentist | 122 Amity Rd, Dr. Dental, New Haven, CT 06515 | 2012-10-30 |
| 1104187673 | Dr.dental of New Haven, PC | Dentist | 122 Amity Road, New Haven, CT 06515 | 2012-05-31 |
| 1548551146 | Allyson Winzer | Speech-Language Pathologist | 901 Edgewood Ave, New Haven, CT 06515 | 2011-04-29 |
| 1326107376 | Jewish Family Service of New Haven Inc. | Clinic/Center | 1440 Whalley Ave, New Haven, CT 06515 | 2006-12-06 |
| 1710959101 | Traci D Nix | Psychologist | 194 Fountain St, New Haven, CT 06515 | 2006-02-01 |
| 1730298936 | Radiologic Assoc of Middletown PC | Radiology | 687 Campbell Ave, West Haven, CT 06515 | 2006-08-30 |
| 1881115657 | Ashley Marie Holodnak | Technician/Technologist | 130 Amity Road, New Haven, CT 06515-0651 | 2017-07-03 |
| 1821599127 | Kyisha Kia Velazquez | Counselor | 446a Blake Street, Suite 200, New Haven, CT 06515-0651 | 2018-02-22 |
| Find all providers in zip 06515 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174951669 | Bela Kirit Dharia | Nurse Practitioner | 55 Lock Street, Yale Health, New Haven, CT 06511-3603 | 2013-10-22 |
| 1841566775 | Leora Hauptman | Nurse Practitioner | 330 Cedar St # 4093, New Haven, CT 06510-3218 | 2012-03-26 |
| 1790909620 | Jayne Foster Linley | Nurse Practitioner | 102 Nash Street, New Haven, CT 06511 | 2007-04-12 |
| 1194842575 | Susan Marie Peters | Nurse Practitioner | 139 Orchard Street, New Haven, CT 06519 | 2007-03-23 |
| 1922165141 | Martha K Swartz | Nurse Practitioner | 789 Howard Ave., Yale New Haven Hospital Pediatric Primary Care Center, New Haven, CT 06510 | 2007-01-03 |
| 1356416747 | Denise Catherine Wagner | Nurse Practitioner | Yale-new Haven Hospital, 20 York Street, Primary Care Center, New Haven, CT 06510 | 2006-11-21 |
| 1174694798 | Nicole Langan Maciejak | Nurse Practitioner | 35 Davis Street, Sbhc, New Haven, CT 06515-1601 | 2006-11-13 |
| 1033224670 | Ivette Becerra Ortiz | Nurse Practitioner | 374 Grand Avenue, Fair Haven Community Health Ctr, New Haven, CT 06513 | 2006-08-21 |
| 1174510440 | Jane Lawrence-riddell | Nurse Practitioner | 1 Long Wharf Dr, Suite 105, New Haven, CT 06511-5991 | 2005-10-03 |
| 1760477012 | Kim Alison Levinson | Nurse Practitioner | 33 Cedar Street, New Haven, CT 06510 | 2005-09-13 |
| Find all providers in NEW HAVEN | ||||
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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.