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Organization
QUINCY PEDIATRIC ASSOCIATES INC
Active
Organization
QUINCY PEDIATRIC ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA BRODERICK (PRACTICE MANAGER)
(781) 837-4044
Entity
Organization
Contact information
Practice address
191 INDEPENDENCE AVE, QUINCY, MA 02169-7751
(617) 773-5070
Mailing address
191 INDEPENDENCE AVE, QUINCY, MA 02169-7751
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
208000000X
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
552112
UNITED HEALTH CARE
MA
01
—
600012B
TUFTS HEALTH PLAN
MA
01
—
601040
HARVARD PILGRIM HEALTH CA
MA
01
—
9101
AETNA
MA
05
—
9700919
—
MA
01
—
M10943
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/09/2006
Last updated
05/23/2014
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