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Organization

THE CHILDRENS CLININIC OF WYOMISSING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JOANNA B BURRIS (CLINICAL DIRECTOR)
(610) 376-8698
Entity
Organization

Contact information

Practice address
2240 RIDGEWOOD RD, SUITE 100, WYOMISSING, PA 19610-1167
(610) 378-1722
(610) 376-8745
Mailing address
2240 RIDGEWOOD RD, SUITE 100, WYOMISSING, PA 19610-1167
(610) 378-1722
(610) 376-8745

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD041246E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007022820002
PA
Enumeration date
07/28/2005
Last updated
08/22/2020
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