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
Fax: (570) 601-1522
Website:
Authorized official contact:
Name: Demay, Joseph Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #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 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1265575955 NPPES
Pennsylvania MEDICAID 0012712310004

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