DOCTORS PEDIATRIC PC - NPI 1083822480 - Pediatrics in Wilton, CT

Q: What is the provider's specialty?

The provider's specialty is Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.

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About Doctors Pediatric Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOCTORS PEDIATRIC PC (NPI 1083822480) is a healthcare organization registered as an adolescent medicine in Wilton, Connecticut and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through May 5, 2027, maintains a secondary practice location in Ridgefield, and lists Christine Macken, Admin, as its authorized official.

NPPES Registry Identity

NPI1083822480

Entity TypeOrganization

Primary Taxonomy2080A0000X

Legal Business NameDOCTORS PEDIATRIC PC

Location Address55 DANBURY RDWilton, CT 06897-4405

Mailing Address55 Danbury RdWilton, CT 06897-4405 · (203) 762-3363 · Fax (203) 762-1999

Phone(203) 762-3363

Fax(203) 762-1999

Organization SubpartNo

Authorized OfficialChristine MackenAdmin · (203) 762-3363

Enumeration DateMay 18, 2007

Last NPPES UpdateFebruary 13, 2025

NPPES CertifiedFebruary 13, 2025

✔ NPI 1083822480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

55 DANBURY RD, Wilton, CT 06897

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Secondary Practice Location 1

Location 110 South StreetRidgefield, CT 06879-4405 · Phone (203) 431-3363

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 07D1012287
Facility Type: Physician Office
Certificate Effective Date: May 06, 2025
Certificate Expiration Date: May 05, 2027
Laboratory Director: JEANNE MILITANA
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Doctors Pediatric Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.