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PORTSMOUTH PEDIATRICS PC NPI 1295044774


NPI Information

NPI: 1295044774
Provider Name: PORTSMOUTH PEDIATRICS, PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 49D0230584

Address:
446 EFFINGHAM ST.
STE 302
PORTSMOUTH, VA
ZIP 23704
Phone: (757) 673-6277
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PORTSMOUTH PEDIATRICS, PC is a pediatrics in Portsmouth, VA. 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. PORTSMOUTH PEDIATRICS, PC NPI is 1295044774. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

446 EFFINGHAM ST.
STE 302
PORTSMOUTH, VA
ZIP 23704
Phone: (757) 673-6277
Fax: (757) 673-6411

The provider's authorized official is Maria A. Delacruz .
The authorized official title is Office Manager and has the following contact phone number (757) 673-6277.

The CLIA number assigned to this NPI record is 49D0230584 - other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/30/2010 and was last updated on 5/22/2013.


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
11295044774MEDICAIDVIRGINIA

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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