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SOUTH PHILADELPHIA PEDIATRICS NPI 1235188475


NPI Information

NPI: 1235188475
Provider Name: SOUTH PHILADELPHIA PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 39D0919090

Address:
1408 S. BROAD STREET FLOOR 2
PHILADELPHIA, PA
ZIP 19146
Phone: (215) 467-3515
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SOUTH PHILADELPHIA PEDIATRICS is a pediatrics in Philadelphia, PA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SOUTH PHILADELPHIA PEDIATRICS NPI is 1235188475. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1408 S. BROAD STREET FLOOR 2
PHILADELPHIA, PA
ZIP 19146
Phone: (215) 467-3515
Fax: (215) 467-0338

The provider's authorized official is Christine Nguyen .
The authorized official title is Partner and has the following contact phone number (215) 467-3515.

The CLIA number assigned to this NPI record is 39D0919090 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/7/2006 and was last updated on 10/25/2018.


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
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11025843220001MEDICAIDPENNSYLVANIA
21027885740001MEDICAIDPENNSYLVANIA
31027096140001MEDICAIDPENNSYLVANIA
41027096410002MEDICAIDPENNSYLVANIA
51027571930001MEDICAIDPENNSYLVANIA

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: 4/28/2024

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