Organization
STC PEDIATRICS LLC
Active
Other names
St. Christopher's Pediatric Associates Adolescent Medicine PCP - E.
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN RAYME (EVP & CFO)
(484) 628-1324
Entity
Organization
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(215) 427-3802
Mailing address
PO BOX 13579, READING, PA 19612-3579
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037317900001
—
PA
Enumeration date
10/30/2019
Last updated
11/06/2025
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