NPIMap

Organization Active NPI

Pediatric Associates of New London, LLC

  • Pediatrics Physician
  • New London, CT
National Provider Identifier
1902011554
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF NEW LONDON, LLC
Practice address
53 Granite St
Suite C
New London, CT 06320-5917
Phone
(860) 442-8817
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Owen R. Ehrlich, M.D., F.A.A.P.NPI 1295835999
Title
Partner
Phone
(860) 442-8817

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X CT Primary

Addresses

Primary practice location

53 Granite St
Suite C
New London, CT 06320-5917

Mailing address

53 Granite St
Suite C
New London, CT 06320-5917
Phone (860) 442-8817

National Provider Directory

National Provider Directory

Locations

53 Granite St
Ste C
New London, CT 06320
Phone (860) 442-8817

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902011554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 GRANITE ST",
            "address_2": "SUITE C",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205917",
            "telephone_number": "860-442-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 GRANITE ST",
            "address_2": "SUITE C",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205917",
            "telephone_number": "860-442-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF NEW LONDON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EHRLICH",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "860-442-8817",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D., F.A.A.P."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.