Organization
PEDIATRIA HEALTHCARE, LLC
Active
Organization
PEDIATRIA HEALTHCARE, LLC
Active
Other names
Pediatria HealthCare for Kiks
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN E. DIGNAN (GENERAL COUNSEL)
(770) 840-1966
Entity
Organization
Contact information
Practice address
53 GRAVEL ST, SUITE C, WILKES BARRE, PA 18705-3738
(570) 371-5600
(570) 371-5606
Mailing address
53 GRAVEL ST, SUITE C, WILKES BARRE, PA 18705-3738
(570) 371-5600
(570) 371-5606
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
2278P3900X
Neonatal/Pediatric Certified Respiratory Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/16/2009
Last updated
02/04/2016
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