Provider Type Icon

PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP P.C. NPI 1164733093


NPI Information

NPI: 1164733093
Provider Name: PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C.
Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

CLIA Number: 22D2015824

Address:
3640 MAIN ST
SUITE 204
SPRINGFIELD, MA
ZIP 01107
Phone: (413) 304-2650
Get Directions

PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C. is a pediatric gastroenterology pediatrics in Springfield, MA. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C. NPI is 1164733093. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3640 MAIN ST
SUITE 204
SPRINGFIELD, MA
ZIP 01107-145
Phone: (413) 304-2650

The provider's authorized official is Susan P Goode .
The authorized official title is President and has the following contact phone number (347) 327-3874.

The CLIA number assigned to this NPI record is 22D2015824 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2010 and was last updated on 6/25/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0206XPediatricsPediatric Gastroenterology233855MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.