Providence Pediatrics
LBN: Providence Pediatrics, Pc
Providence Pediatrics is an health care organization with primary practice located at 338 Russell Avenue , Williamsport PA 17701. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is the primary health care specialty.
Providence Pediatrics, Pc can be contacted via phone (570) 326-5720, or through Demay, Joseph via phone (570) 326-5720.
Contact Information
Primary practice address
338 Russell Avenue
Williamsport PA 17701
Phone: (570) 326-5720
Fax: (570) 601-1522
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD046306-L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | MD046306L | Pennsylvania |
Profile Details
| NPI number | 1265575955 |
|---|---|
| LBN Legal business name | Providence Pediatrics, Pc |
| DBA Doing business as | Providence Pediatrics |
| Authorized official | Demay, Joseph Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 14th, 2007 |
| Last updated | Jan 11th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265575955 | NPPES |
| Pennsylvania | MEDICAID | 0012712310004 |
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