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KIDS STATION PEDIATRICS
NPI 1417153677
Pediatrics - Adolescent Medicine in Manchester, CT

Active since June 25, 2007
191 MAIN ST, MANCHESTER, CT 06042(860) 643-7973(860) 643-0175 Get Directions Write a Review

NPPES record last updated: October 8, 2013. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Kids Station Pediatrics NPPES

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

KIDS STATION PEDIATRICS (NPI 1417153677) is a healthcare organization registered as an adolescent medicine in Manchester, Connecticut and active in the NPI registry since June 2007. The organization lists Donald Francis Mordavsky, Ceo, as its authorized official.

NPPES Registry Identity

NPI1417153677
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameKIDS STATION PEDIATRICS
Location Address191 MAIN STManchester, CT 06042-3556
Mailing Address191 Main StManchester, CT 06042-3556 · (860) 643-7973 · Fax (860) 643-0175
Phone(860) 643-7973
Fax(860) 643-0175
Organization SubpartNo
Authorized OfficialDonald Francis MordavskyCeo · (860) 643-7973
Enumeration DateJune 25, 2007
Last NPPES UpdateOctober 8, 2013
✔ NPI 1417153677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
191 MAIN ST, Manchester, CT 06042
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Other Identifiers 1

Medicaid004132651CT

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

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

RETINA CONSULTANTS PC
Ophthalmology
191 MAIN ST
MANCHESTER, CT 06042
Capitol Planning Region (860) 646-7704
PETER H. JUDSON M.D.
Ophthalmology
191 MAIN ST
MANCHESTER, CT 06042
Capitol Planning Region (860) 646-7704
MARION J. STOJ M.D.
Ophthalmology
191 MAIN ST
MANCHESTER, CT 06042
Capitol Planning Region (860) 646-7704
DR. RON MARGOLIS M.D.
Ophthalmology
191 MAIN ST
MANCHESTER, CT 06042
Capitol Planning Region (860) 646-7704
NOAM RUDNICK MD
Ophthalmology
191 MAIN ST
MANCHESTER, CT 06042
Capitol Planning Region (860) 646-7704
DR. JERRY NEUWIRTH MD
Ophthalmology
191 MAIN ST
MANCHESTER, CT 06042
Capitol Planning Region (860) 646-7704

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 Kids Station Pediatrics's NPI number?

The NPI number for Kids Station Pediatrics is 1417153677. It was assigned to this organization in the NPPES registry on June 25, 2007.

Where is Kids Station Pediatrics located?

Kids Station Pediatrics is located at 191 Main St, Manchester, CT 06042. The listed phone number is (860) 643-7973.

What is Kids Station Pediatrics's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

When was this NPI record last updated?

The NPPES record for Kids Station Pediatrics was last updated on October 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.