Main Street Pediatrics, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MAIN STREET PEDIATRICS, PC

Practice address

3180 Main St
Main Street Pediatrics, PC
Bridgeport, CT 06606-4237

Phone

(203) 371-7111

NPI assigned

Mar 8, 2007

Last updated

Jul 10, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Roy E Schutzengel, MD

Title

President

Phone

(203) 371-7111

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1043341621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 MAIN ST",
            "address_2": "MAIN STREET PEDIATRICS, PC",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064237",
            "telephone_number": "203-371-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 MAIN ST",
            "address_2": "MAIN STREET PEDIATRICS, PC",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064237",
            "telephone_number": "203-371-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "SCHUTZENGEL",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-371-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rakesh Mahali, MD
• Emily Mai, PHARMD
• Adriana Maia, APRN, FNP-C
• Fritz Maignan, MS, NCC, LPC
• Jackson P Maille, MD
• Main Street Pharmacy 3 LLC
• Main Street Pharmacy 3 LLC (Main Street Pharmacy)
• Main Street Pharmacy LLC (Main Street Pharmacy)
• Kenneth Joseph Maiocco, M.D.
• Melinda Joan Maisano

• Pediatrics Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.