Organization
PREMIER PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER DANA DIABO MD (MEDICAL DIRECTOR)
(215) 423-1011
Entity
Organization
Contact information
Practice address
2318 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4432
(215) 423-1011
(215) 423-6743
Mailing address
2318 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4432
(215) 423-1011
(215) 423-6743
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD417182
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019068950003
—
PA
Enumeration date
07/25/2006
Last updated
08/22/2020
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