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PANDA BEAR PEDIATRICS NPI 1497788327


NPI Information

NPI: 1497788327
Provider Name: PANDA BEAR PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 39D1027913

Address:
555 SOUTH SECOND AVENUE
BUILDING B, SUITE 200
COLLEGEVILLE, PA
ZIP 19426
Phone: (610) 409-8050
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PANDA BEAR PEDIATRICS is a pediatrics in Collegeville, 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. PANDA BEAR PEDIATRICS NPI is 1497788327. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

555 SOUTH SECOND AVENUE
BUILDING B, SUITE 200
COLLEGEVILLE, PA
ZIP 19426-854
Phone: (610) 409-8050
Fax: (610) 409-8075

The provider's authorized official is Larissa F Dominy .
The authorized official title is Physician/managing Member and has the following contact phone number (610) 409-8050.

The CLIA number assigned to this NPI record is 39D1027913 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 8/22/2020.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsOS-009162LPENNSYLVANIAYes

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: 5/5/2024

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