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STAYWELL PEDIATRIC LLC
NPI 1255521019
Nurse Practitioner - Pediatrics in West Haven, CT

Active since July 27, 2007
365 ELM ST, WEST HAVEN, CT 06516(203) 932-3227(203) 931-2847 Get Directions Write a Review

NPPES record last updated: July 27, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Staywell Pediatric Llc NPPES

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

STAYWELL PEDIATRIC LLC (NPI 1255521019) is a healthcare organization registered as a pediatrics in West Haven, Connecticut and active in the NPI registry since July 2007. The organization lists Thomas Etkin, Owner, as its authorized official.

NPPES Registry Identity

NPI1255521019
Entity TypeOrganization
Primary Taxonomy363LP0200X
Legal Business NameSTAYWELL PEDIATRIC LLC
Location Address365 ELM STWest Haven, CT 06516-4217
Mailing Address365 Elm StWest Haven, CT 06516-4217 · (203) 932-3227 · Fax (203) 931-2847
Phone(203) 932-3227
Fax(203) 931-2847
Organization SubpartNo
Authorized OfficialThomas EtkinOwner · (230) 932-3227
Enumeration DateJuly 27, 2007
✔ NPI 1255521019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in CT · 000373
365 ELM ST, West Haven, CT 06516
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

DR. SIMONE K. SIMON M.D.
Pediatrics
365 ELM ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 932-3227
JOBEY JACOB M.D.
Pediatrics
365 ELM ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 932-3227
STAYWELL PEDIATRIC LLC
Pediatrics (Adolescent Medicine)
365 ELM ST
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 932-3227

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 Staywell Pediatric LLC's NPI number?

The NPI number for Staywell Pediatric LLC is 1255521019. It was assigned to this organization in the NPPES registry on July 27, 2007.

Where is Staywell Pediatric LLC located?

Staywell Pediatric LLC is located at 365 Elm St, West Haven, CT 06516. The listed phone number is (203) 932-3227.

What is Staywell Pediatric LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Staywell Pediatric LLC was last updated on July 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.