Kids Station Pediatrics
NPI 1417153677 · Pediatric Adolescent Medicine Physician · Manchester, CT
Kids Station Pediatrics is a Pediatric Adolescent Medicine Physician organization in Manchester, CT (NPI 1417153677).
Provider details
- NPI number
- 1417153677
- Entity type
- Organization
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Mordavsky, Ceo(860) 643-7973
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatric Nurse Practitioner363LP0200X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-06-25
- Last updated
- 2013-10-08
Frequently asked questions
- What is Kids Station Pediatrics's NPI number?
- Kids Station Pediatrics's National Provider Identifier (NPI) is 1417153677, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kids Station Pediatrics?
- Kids Station Pediatrics is classified in the NPPES registry as Pediatric Adolescent Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Kids Station Pediatrics located?
- Kids Station Pediatrics's practice location on file with NPPES is 191 Main St, Manchester, CT 06042-3556.
- What is Kids Station Pediatrics's phone number?
- The practice phone number listed in the NPPES registry for Kids Station Pediatrics is (860) 643-7973.
- Who is the authorized official for Kids Station Pediatrics?
- The authorized official listed on Kids Station Pediatrics's NPPES record is Donald Mordavsky, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kids Station Pediatrics's NPI active?
- Yes — Kids Station Pediatrics's NPI (1417153677) is active in the NPPES registry as of the last update on 2013-10-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.