WAKE SPECIALTY PHYSICIANS LLC NPI 1659934511

NPI Information

  • NPI: 1659934511
  • Provider Name: WAKE SPECIALTY PHYSICIANS, LLC
  • Classification: Pediatrics - 2080P0006X
  • Specialization: Developmental - Behavioral Pediatrics
  • Entity Type: Organization
  • Doing Business As: WAKEMED CHILDREN'S-PEDIATRIC BEHAVIORAL HEALTH
  • Address: 23 SUNNYBROOK RD
    RALEIGH, NC
    ZIP 27610
  • Phone: (919) 350-8797

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NPI Details

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11942440375MEDICAIDNORTH CAROLINA

What is NPI?

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This page was last updated on: 11/21/2025

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