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MIDDLEBORO PEDIATRICS PC NPI 1861556961


NPI Information

NPI: 1861556961
Provider Name: MIDDLEBORO PEDIATRICS, PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 22D0079985

Address:
2 LAKEVILLE BUSINESS PARK
LAKEVILLE, MA
ZIP 02347
Phone: (508) 947-0630
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MIDDLEBORO PEDIATRICS, PC is a pediatrics in Lakeville, 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. MIDDLEBORO PEDIATRICS, PC NPI is 1861556961. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2 LAKEVILLE BUSINESS PARK
LAKEVILLE, MA
ZIP 02347-236
Phone: (508) 947-0630
Fax: (508) 947-0639

The provider's authorized official is Neal Gerald Bornstein .
The authorized official title is President and has the following contact phone number (508) 947-0630.

The CLIA number assigned to this NPI record is 22D0079985 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 10/27/2011.


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
19718605MEDICAIDMASSACHUSETTS
2713191OTHERMASSACHUSETTSTUFTS HEALTH CARE GROUP #
3M13187MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS

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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