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PEDIATRIC SERVICE GROUP NPI 1770539066


NPI Information

NPI: 1770539066
Provider Name: PEDIATRIC SERVICE GROUP
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
750 E. ADAMS ST.
5TH FLOOR
SYRACUSE, NY
ZIP 13210
Phone: (315) 464-5450
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PEDIATRIC SERVICE GROUP is a pediatrics in Syracuse, NY. 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. PEDIATRIC SERVICE GROUP NPI is 1770539066. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

750 E. ADAMS ST.
5TH FLOOR
SYRACUSE, NY
ZIP 13210
Phone: (315) 464-5450
Fax: (315) 464-7564

The provider's authorized official is Thomas Welch .
The authorized official title is Chairman Of Department and has the following contact phone number (315) 464-5450.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 10/22/2010.


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
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
101215750MEDICAIDNEW YORK
256651AMEDICARE PINNEW YORK

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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