Enfield Pediatric Associates,P.C.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

032642 Issued in CT

Legal business name

ENFIELD PEDIATRIC ASSOCIATES,P.C.

Practice address

155 Hazard Ave Ste 14
Enfield, CT 06082-4586

Phone

(860) 749-3169

NPI assigned

Sep 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Ross William Porter, M.D.

Title

President

Phone

(860) 749-3169

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1225319445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 HAZARD AVE STE 14",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824586",
            "telephone_number": "860-749-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HAZARD AVE STE 14",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824586",
            "telephone_number": "860-749-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENFIELD PEDIATRIC ASSOCIATES,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-749-3169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "032642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enfield Club Properties, LLC
• Enfield Compounding Center LLC
• Enfield Compounding Pharmacy LLC
• Enfield Dermatology LLC
• Enfield Eyecare Associates, L.L.P.
• Enfield Pediatric Dentistry LLC
• Enfield Plaza Family Dental
• Enfield Public Schools
• Enfield Surgery Center, LLC
• Zorica Engelhardt, DDS

• Pediatric Adolescent Medicine Physician in Enfield, CT
• Providers in Enfield, CT by specialty
• Pediatric Adolescent Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.