TOWN AND COUNTRY PEDIATRICS AND FAMILY MEDICINE, P.C. (NPI# 1942414081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942414081 |
| Entity Type | Organization |
| Organization Name | TOWN AND COUNTRY PEDIATRICS AND FAMILY MEDICINE, P.C. |
| Practice Address |
380 Main Street Watertown CT 06795 |
| Practice Telephone | 8602748891 |
| Practice Fax Number | 8602748895 |
| Mailing Telephone | 8602748891 |
| Mailing Fax Number | 8602748895 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2012-12-12 |
| Authorized Official Name | DR. JACQUELINE O LUSTIG (PRESIDENT) |
| Authorized Official Telephone | 8602748891 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 041948 | CT | Allopathic & Osteopathic Physicians |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
001457 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208000000X | Pediatrics | 035903 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
380 MAIN STREET |
| City | WATERTOWN |
| State | CT |
| Zip Code | 06795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396232187 | Watertown Wellness Center LLC | Community/Behavioral Health | 116 Georgetown Drive, Watertown, CT 06795 | 2018-04-17 |
| 1134569833 | Kara Marie Iacoviello | Occupational Therapist | 18 Wilder St, Watertown, CT 06795 | 2013-06-27 |
| 1821348871 | Pamela D Siemon | Social Worker | 51 Depot St Ste 207, Watertown, CT 06795 | 2012-09-18 |
| 1073891222 | Alexander Pantelis Tinios | Student in an Organized Health Care Education/Training Program | 163 Townline Hwy, Watertown, CT 06795 | 2011-07-21 |
| 1083919757 | Connecticut Music Therapy Services, LLC | Music Therapist | 51 Depot St., Suite 214, Watertown, CT 06795 | 2011-01-11 |
| 1083841456 | Erica Lee Opromollo | Social Worker | 35 Scott Ave, Watertown, CT 06795 | 2009-06-12 |
| 1033306816 | Stone Chiropractic LLC | Chiropractor | 51 Depot Square, Watertown, CT 06795 | 2007-09-26 |
| 1174640205 | Sheila Whitman | Counselor | 686 Main Street, Watertown, CT 06795 | 2007-03-23 |
| 1225146848 | Ronald Joseph Dandrea | Internal Medicine | 51 Depot Street, Watertown, CT 06795 | 2006-08-25 |
| 1417344607 | Peter Anthony Ferrante | Podiatrist | 777 Echo Lake Rd Unit F, Watertown, CT 06795 | 2015-04-25 |
| Find all providers in zip 06795 | ||||
| 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 |
|---|---|---|---|---|
| 1689715658 | Teresa M. Kohlenberg | Pediatrics | 93 Garfield St, Watertown, MA 02472-4914 | 2007-02-10 |
| 1861589384 | Child and Adolescent Health Associates | Pediatrics | 513 Washington Street, Watertown, NY 13601-4001 | 2006-10-06 |
| 1265474894 | Brigido C Calado | Pediatrics | 1532 Utah St, Watertown, WI 53094-6410 | 2006-06-11 |
| 1477593069 | Robert Dennis Bacsik | Pediatrics | 435 Harris Dr, Watertown, NY 13601-4205 | 2006-06-08 |
| 1811947393 | Mario Francisco Victoria | Pediatrics | 18969 Us Route 11, 5699 Outer Washington Street, Watertown, NY 13601-5320 | 2006-05-12 |
| 1396702882 | Craig E. Crismon | Pediatrics | 511 14th Ave Ne, Watertown, SD 57201-6811 | 2006-04-27 |
| 1457326803 | Aida M. Yavshayan | Pediatrics | 375 Mount Auburn St, Watertown, MA 02472 | 2006-02-21 |
| 1225034119 | Karie Ann Mantey | Pediatrics | 134 Hospital Dr, Watertown, WI 53098-3304 | 2005-06-24 |
| 1285241307 | Ahmad Chatila | Pediatrics | 20011 Summit View Blvd, Watertown, NY 13601-1996 | 2020-09-24 |
| 1437437043 | Stephanie Ann Oliva | Pediatrics | 18969 Us Route 11, Pediatric Associates of Watertown, Watertown, NY 13601-6329 | 2011-07-31 |
| Find all providers in WATERTOWN | ||||
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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.