WILDWOOD PEDIATRICS AND ADOLESCENT MEDICINE LLC - NPI 1750405023

Q: What is Wildwood Pediatrics And Adolescent Medicine LLC's specialty?

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

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About Wildwood Pediatrics And Adolescent Medicine Llc NPPES

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

WILDWOOD PEDIATRICS AND ADOLESCENT MEDICINE LLC (NPI 1750405023) is a healthcare organization registered as a pediatrics in Essex, Connecticut and active in the NPI registry since March 2007. The organization holds 2 active CLIA laboratory certificates and lists Christopher W Goff, Partner, as its authorized official.

NPPES Registry Identity

NPI1750405023

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameWILDWOOD PEDIATRICS AND ADOLESCENT MEDICINE LLC

Location AddressONE WILDWOOD MEDICAL CENTEREssex, CT 06426

Mailing AddressOne Wildwood Medical CenterEssex, CT 06426 · (860) 767-0168 · Fax (860) 767-1803

Phone(860) 767-0168

Fax(860) 767-1803

Organization SubpartNo

Authorized OfficialChristopher W GoffPartner · (860) 767-0168

Enumeration DateMarch 19, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1750405023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

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.

ONE WILDWOOD MEDICAL CENTER, Essex, CT 06426

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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

CLIA Laboratory Certificates CMS CLIA 2

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 07D0096368

Wildwood Pediatrics And Adolescent Medicine · Essex, CT

Active · expires Jan 5, 2028

CLIA Number07D0096368

Laboratory TypePhysician Office

Certificate Effective DateJanuary 6, 2026

Certificate Expiration DateJanuary 5, 2028

Laboratory DirectorJennifer A. Baldwin

Laboratory Phone(860) 767-0168

Laboratory LocationWildwood Pediatrics And Adolescent Medicine1 Wildwood Medical Center, Essex, CT 06426

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 07D0097484

Wildwood Pediatrics & Adolescent Medicine · Old Saybrook, CT

Active · expires Dec 30, 2027

CLIA Number07D0097484

Laboratory TypePhysician Office

Certificate Effective DateDecember 31, 2025

Certificate Expiration DateDecember 30, 2027

Laboratory DirectorJennifer A. Baldwin

Laboratory Phone(860) 767-0168

Laboratory LocationWildwood Pediatrics & Adolescent Medicine30 Elm Street, Old Saybrook, CT 06475

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

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.

MICHELLE ELIZABETH DILORENZO DO

Pediatrics

ONE WILDWOOD MEDICAL CENTER
ESSEX, CT 06426