Organization
STC PEDIATRICS LLC
Active
Organization
STC PEDIATRICS LLC
Active
Other names
St. Christopher's Pediatric Associates Special Needs - Dietitians
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES MICHAEL VALENTINO JR. (VP OF REVENUE INTEGRITY)
(484) 628-9380
Entity
Organization
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(215) 427-8363
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-1324
(484) 331-7026
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133V00000X
Registered Dietitian
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037317900102
—
PA
Enumeration date
10/05/2020
Last updated
06/02/2026
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