1811322738 NPI number — SINGULAR PEDIATRICS L.L.C.

Table of content: (NPI 1811322738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811322738 NPI number — SINGULAR PEDIATRICS L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SINGULAR PEDIATRICS L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR. RISKO PEDIATRICS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811322738
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 UNION ST
Provider Second Line Business Mailing Address:
NEWTON CENTRE
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02459-2057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-209-3933
Provider Business Mailing Address Fax Number:
857-404-0581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 UNION ST
Provider Second Line Business Practice Location Address:
NEWTON CENTRE
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02459-2057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-209-3933
Provider Business Practice Location Address Fax Number:
857-404-0581
Provider Enumeration Date:
09/10/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RISKO
Authorized Official First Name:
WANESSA
Authorized Official Middle Name:
P
Authorized Official Title or Position:
RESIDENT AGENT OF SING.PEDS LLC
Authorized Official Telephone Number:
617-209-3933

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  78884 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com