NPIMap

Organization Active NPI

Choate Rosemary Hall Foundation

  • Pediatric Adolescent Medicine Physician
  • Wallingford, CT
National Provider Identifier
1609186816
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
CHOATE ROSEMARY HALL FOUNDATION
Practice address
333 Christian Street
Wallingford, CT 06492
Phone
(203) 697-2203
Fax
(203) 697-2294
NPI assigned
Oct 21, 2010
Last updated
Oct 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Authorized official

Name
Dr. E. Benjamin Gardner, MD
Title
Director of Health Services
Phone
(203) 697-2203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

333 Christian Street
Wallingford, CT 06492

Mailing address

333 Christian Street
Wallingford, CT 06492
Phone (203) 697-2203

National Provider Directory

National Provider Directory

Locations

333 Christian St
Wallingford, CT 06492
Phone (203) 697-2000

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1609186816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CHRISTIAN STREET",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-697-2203",
            "fax_number": "203-697-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CHRISTIAN STREET",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-697-2203",
            "fax_number": "203-697-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOATE ROSEMARY HALL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "E. BENJAMIN",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SERVICES",
        "authorized_official_telephone_number": "203-697-2203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.