Organization
DEVELOPMENTAL INTEGRATIVE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTYN BILLINGS (INSURANCE DEPT)
(412) 655-4362
Entity
Organization
Contact information
Practice address
60 ABELE RD STE 1105A, BRIDGEVILLE, PA 15017-3467
(412) 221-0800
Mailing address
PO BOX 791, CARNEGIE, PA 15106-0791
(141) 265-5436
(412) 653-7684
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD065544L
STATE LICENSE
PA
Enumeration date
12/18/2018
Last updated
12/18/2018
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