PEDIATRIC HEMATOLOGY/ONCOLOGY SPECIALISTS NPI 1275710907

NPI Information

NPI: 1275710907
Provider Name: PEDIATRIC HEMATOLOGY/ONCOLOGY SPECIALISTS
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
601 S FLOYD ST
SUITE 403
LOUISVILLE, KY
ZIP 40202
Phone: (502) 629-7750
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PEDIATRIC HEMATOLOGY/ONCOLOGY SPECIALISTS is a pediatrics nurse practitioner in Louisville, KY. PEDIATRIC HEMATOLOGY/ONCOLOGY SPECIALISTS NPI is 1275710907. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

601 S FLOYD ST
SUITE 403
LOUISVILLE, KY
ZIP 40202-835
Phone: (502) 629-7750
Fax: (502) 629-7784

The provider's authorized official is Salvatore James Bertolone .
The authorized official title is President and has the following contact phone number (502) 629-7750.

The enumeration date for this NPI number is 1/24/2008 and was last updated on 1/24/2008.

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
1	363LF0000X	Nurse Practitioner	Family		KENTUCKY	No
2	363LP0200X	Nurse Practitioner	Pediatrics		KENTUCKY	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	78905171	MEDICAID	KENTUCKY

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

NPI Synchronization or Removal

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