Providence Pediatric Practice Llc

LBN: Providence Pediatric Practice Llc
Providence Pediatric Practice Llc is an health care organization with primary practice located at 100 Granite Dr Suite 200, Media PA 19063-5134. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Providence Pediatric Practice Llc can be contacted via phone (610) 565-1945, or through Gibbons, Jacquelyn H via phone (610) 565-1945.

Contact Information

Primary practice address
100 Granite Dr Suite 200 Media PA 19063-5134
Phone: (610) 565-1945
Fax: (610) 892-7848
Website:
Map and Directions
Authorized official contact:
Name: Gibbons, Jacquelyn H Doctor of Medicine (MD)
Phone: (610) 565-1945

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1932160629
LBN Legal business name Providence Pediatric Practice Llc
DBA Doing business as
Authorized official Gibbons, Jacquelyn H Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2006
Last updated Mar 18th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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