Heidi Bryna Wildstein, APRN MSN
Individual provider Active NPI Developmental - Behavioral Pediatrics Physician · Cheshire, CT
NPI 1750355772 · NPPES record last updated Oct 29, 2021
Key facts
- NPI
- 1750355772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental - Behavioral Pediatrics Physician 2080P0006X
- License
- 2442 (CT)
- Practice address
- 422 Highland Ave
Cheshire, CT 06410-2526 - Phone
- (203) 304-4961
- Fax
- (203) 306-2905
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002442 | CT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Current |
Accepting new patients | |
| Bright Futures Wellness Center, LLC | Developmental - Behavioral Pediatrics | Current | Accepting new patients |
| Yale University | Current | Accepting new patients | |
| Yale University | Current |
Accepting new patients |
Locations
282 Washington St
Hartford, CT 06106
Phone (860) 545-8950
1 Long Wharf Dr
New Haven, CT 06511
Phone (203) 777-7500
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 002442 | CT | |
| Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0807X | 2442 | CT | |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 2442 | CT | Yes |
Addresses
Primary practice location
422 Highland Ave
Cheshire, CT 06410-2526
Mailing address
PO Box 9805
300 George St, 6TH Floor
New Haven, CT 06536-0805
Phone (203) 785-7998
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004218740 | Medicaid | CT |
Other providers in Cheshire, CT
- Eva Whelan
- Lisa Lee Whitaker
- Wholistic Perspective
- Nicole Mary Wichowski
- Richard Bertram Wilber
- Kristin Wiley
- Allison Williams
- Richard G Williams
- Hannah Wilson
- Vernette Wilson
All providers in Cheshire, CT · Developmental - Behavioral Pediatrics Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.