Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

New Haven Pediatric & Adolescent Medical Serv

Organization Pediatrics Physician · NPI 1962680934

New Haven Pediatric & Adolescent Medical Serv provides Pediatrics Physician services in New Haven, Connecticut. Licensed in Connecticut. Registered with an NPI since 2008.

Licensed in
CT
In the registry since
2008
Specialties on file
2

Practice location Address checks out

1423 Chapel St Unit 2B
New Haven, CT 06511 Not confirmed with CMS for 18 years — call before visiting
Phone: (203) 752-0706
Fax: (203) 772-0387
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 0136872 (CT)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 0002815 (CT)

Record details

NPI number1962680934
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Angel Jackson — Office Manager · (203) 906-3854
Other names Tamiko V Jackson Md
NPI enumeratedFebruary 1, 2008
Last updated in NPPESFebruary 1, 2008
Mailing address1423 Chapel St, Unit 2b, New Haven, CT 06511

Other providers in New Haven