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HOLLISTONPEDIATRIC GROUP NPI 1538184692


NPI Information

NPI: 1538184692
Provider Name: HOLLISTONPEDIATRIC GROUP
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 22D0972161

Address:
100 JEFFREY AVE
HOLLISTON, MA
ZIP 01746
Phone: (508) 478-5996
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HOLLISTONPEDIATRIC GROUP is a pediatrics in Holliston, MA. 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. HOLLISTONPEDIATRIC GROUP NPI is 1538184692. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 JEFFREY AVE
HOLLISTON, MA
ZIP 01746-028
Phone: (508) 478-5996
Fax: (508) 482-9147

The provider's authorized official is Linda L Vaillette .
The authorized official title is Practice Manager and has the following contact phone number (508) 478-5996.

The CLIA number assigned to this NPI record is 22D0972161 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/12/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics52479MASSACHUSETTSYes

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
1M10882OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
2701376OTHERMASSACHUSETTSTUFTS HEALTH PLAN
39749403MEDICAIDMASSACHUSETTS

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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