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EAST AVENUE PEDIATRICS PC
NPI 1093092165
Pediatrics in Norwalk, CT

Active since November 03, 2011CLIA 07D2042246 · Waiver
148 EAST AVE, SUITE 1L, NORWALK, CT 06851(203) 854-6993(203) 854-9227 Get Directions Write a Review

NPPES record last updated: November 3, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About East Avenue Pediatrics Pc NPPES

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

EAST AVENUE PEDIATRICS PC (NPI 1093092165) is a healthcare organization registered as a pediatrics in Norwalk, Connecticut and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through June 6, 2028 and lists Libia Rueda-matik, Physician, as its authorized official.

NPPES Registry Identity

NPI1093092165
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameEAST AVENUE PEDIATRICS PC
Location Address148 EAST AVE, SUITE 1LNorwalk, CT 06851-5721
Mailing Address148 East Ave, Suite 1lNorwalk, CT 06851-5721 · (203) 854-6993 · Fax (203) 854-9227
Phone(203) 854-6993
Fax(203) 854-9227
Organization SubpartNo
Authorized OfficialLibia Rueda-matikPhysician · (203) 854-6993
Enumeration DateNovember 3, 2011
✔ NPI 1093092165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CT · 038173
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

148 EAST AVE, Norwalk, CT 06851
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Other Identifiers 1

Medicaid001381730CT

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 Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2042246

East Avenue Pediatrics, PC · Norwalk, CT
Active · expires Jun 6, 2028
CLIA Number07D2042246
Laboratory TypePhysician Office
Certificate Effective DateJune 7, 2026
Certificate Expiration DateJune 6, 2028
Laboratory DirectorDr. Libia Rueda-Matik
Laboratory Phone(203) 854-6993
Laboratory LocationEast Avenue Pediatrics, PC148 East Avenue Suite 1 L, Norwalk, CT 06851
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER I FRIMMER MD
Radiology (Diagnostic Radiology)
148 EAST AVE
NORWALK, CT 06851
Western Connecticut Planning Region (203) 852-9913
MARTIN D. ARKIN, P.C.
Optometrist
148 EAST AVE
NORWALK, CT 06851
Western Connecticut Planning Region (203) 866-3280
DR. ALAN H RICHMAN MD
Radiology (Diagnostic Radiology)
148 EAST AVE
NORWALK, CT 06851
Western Connecticut Planning Region (203) 852-2715
RONALD P LEE MD
Radiology (Diagnostic Radiology)
148 EAST AVE
NORWALK, CT 06851
Western Connecticut Planning Region (203) 852-9913
CARLA ANN REYNOLDS APRN
Nurse Practitioner (Family)
148 EAST AVE
NORWALK, CT 06851
Western Connecticut Planning Region (203) 538-5682
DR. GARY A LETTS M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
148 EAST AVE, STE 2D
NORWALK, CT 06851
Western Connecticut Planning Region (203) 832-3737
FAIRFIELD COUNTY COLOPROCTOLOGY GROUP, LLC
Colon & Rectal Surgery
148 EAST AVE, SUITE 3B
NORWALK, CT 06851
Western Connecticut Planning Region (203) 853-1705
SYED JAVED SHAHID MD
Neurological Surgery
148 EAST AVE, SUITE 3D
NORWALK, CT 06851
Western Connecticut Planning Region (203) 853-0003

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Avenue Pediatrics PC's NPI number?

The NPI number for East Avenue Pediatrics PC is 1093092165. It was assigned to this organization in the NPPES registry on November 3, 2011.

Where is East Avenue Pediatrics PC located?

East Avenue Pediatrics PC is located at 148 East Ave Suite 1L, Norwalk, CT 06851. The listed phone number is (203) 854-6993.

What is East Avenue Pediatrics PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does East Avenue Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2042246) is associated with this NPI, valid through June 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Avenue Pediatrics PC was last updated on November 3, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.