Provider Demographics
NPI:1790974012
Name:THE HEALTHY CHILD,L.L.C.
Entity Type:Organization
Organization Name:THE HEALTHY CHILD,L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:P
Authorized Official - Last Name:WINDELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-655-6000
Mailing Address - Street 1:722 POST RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4731
Mailing Address - Country:US
Mailing Address - Phone:203-655-6000
Mailing Address - Fax:203-655-6003
Practice Address - Street 1:722 POST RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4731
Practice Address - Country:US
Practice Address - Phone:203-655-6000
Practice Address - Fax:203-655-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT20432OtherHEALTHNET
CT10446988OtherCAQH
CT4228671OtherAETNA
CT010028744CT02OtherBLUE CROSS-DARIEN
CTZP285OtherOXFORD
CT287440OtherCONNECTICARE
CTZP285OtherOXFORD