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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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