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WAKE SPECIALTY PHYSICIANS LLC NPI 1659934511


NPI Information

NPI: 1659934511
Provider Name: WAKE SPECIALTY PHYSICIANS, LLC

Doing Business As: WAKEMED CHILDREN'S-PEDIATRIC BEHAVIORAL HEALTH

Classification: Pediatrics - 2080P0006X
Entity Type: Organization

Specialization: Developmental - Behavioral Pediatrics

Address:
23 SUNNYBROOK RD
RALEIGH, NC
ZIP 27610
Phone: (919) 350-8797
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WAKE SPECIALTY PHYSICIANS, LLC is a developmental - behavioral pediatrics pediatrics in Raleigh, NC. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. WAKE SPECIALTY PHYSICIANS, LLC NPI is 1659934511. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Wakemed Children's-pediatric Behavioral Health.

The provider's business location address is:

23 SUNNYBROOK RD
RALEIGH, NC
ZIP 27610-855
Phone: (919) 350-8797
Fax: (919) 350-7859

The provider's authorized official is Maria Jayoussi .
The authorized official title is Executive Vp Of Finance and has the following contact phone number (919) 350-0554.

The enumeration date for this NPI number is 4/17/2019 and was last updated on 7/24/2019.


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
12080P0006XPediatricsDevelopmental - Behavioral PediatricsYes

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
11942440375MEDICAIDNORTH CAROLINA

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

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