| East Lyme Pediatric Clinic, Llc | |
|
170 Flanders Rd Niantic CT 06357-1208 | |
| (860) 739-7444 | |
| (860) 739-3252 |
| Full Name | East Lyme Pediatric Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 170 Flanders Rd, Niantic, Connecticut |
| Authorized Official Name and Position | Sajda Perween Malik (MEMBER) |
| Authorized Official Contact | 8607397444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Lyme Pediatric Clinic, Llc 170 Flanders Rd Niantic CT 06357-1208 Ph: (860) 739-7444 | East Lyme Pediatric Clinic, Llc 170 Flanders Rd Niantic CT 06357-1208 Ph: (860) 739-7444 |
| NPI Number | 1326265745 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 03/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326265745 | NPI | - | NPPES |
| 001365263 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 27074 (Connecticut) | Primary |
Southeastern Ct Primary Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Liberty Way Unit B10, Niantic, CT 06357 Phone: 860-691-8084 Fax: 860-691-1195 | |
Guardian Health Center, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 179 Flanders Rd, Niantic, CT 06357 Phone: 860-949-3040 | |
David D Thompson Jr & Robert A Linden Ptr Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 22 W Main St, Niantic, CT 06357 Phone: 860-739-4431 Fax: 860-739-9461 |