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LIBERTY PEDIATRICS LLC NPI 1568860294


NPI Information

NPI: 1568860294
Provider Name: LIBERTY PEDIATRICS, LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1030 LIBERTY RD
SUITE 100
ELDERSBURG, MD
ZIP 21784
Phone: (410) 549-0900
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LIBERTY PEDIATRICS, LLC is a clinic center in Eldersburg, MD. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). LIBERTY PEDIATRICS, LLC NPI is 1568860294. The provider is registered as an organization entity type.

The provider's business location address is:

1030 LIBERTY RD
SUITE 100
ELDERSBURG, MD
ZIP 21784-941
Phone: (410) 549-0900
Fax: (410) 549-6121

The provider's authorized official is Thomas D. Hickey .
The authorized official title is Owner and has the following contact phone number (410) 549-0900.

The enumeration date for this NPI number is 12/11/2014 and was last updated on 12/11/2014.


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
1261Q00000XClinic/CenterR213300MARYLANDYes

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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