Organization
CHILDEN'S COMMUNITY CARE
Active
Other names
Children's Community Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
LORI MARTINEZ (EXECUTIVE ADMINISTRATOR III)
(724) 933-1100
Entity
Organization
Contact information
Practice address
119 VIP DR, WEXFORD, PA 15090-7976
(724) 935-6644
(724) 935-9644
Mailing address
103 BRADFORD RD STE 200, WEXFORD, PA 15090-6910
(724) 933-1100
(724) 933-1160
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/22/2020
Last updated
09/13/2023
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