Organization
PORTSMOUTH PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA A. DELACRUZ (OFFICE MANAGER)
(757) 673-6277
Entity
Organization
Contact information
Practice address
446 EFFINGHAM ST., STE 302, PORTSMOUTH, VA 23704
(757) 673-6277
(757) 673-6411
Mailing address
446 EFFINGHAM ST., STE. 302, PORTSMOUTH, VA 23704
(757) 673-6277
(757) 673-6411
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295044774
—
VA
Enumeration date
09/30/2010
Last updated
05/22/2013
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