Organization
PEDIATRIC SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZERBA (ADMINISTRATIVE OFFICE MANAGER)
(952) 922-4200
Entity
Organization
Contact information
Practice address
4700 PARK GLEN RD, ST LOUIS PARK, MN 55416-5701
(952) 922-4200
(952) 922-4301
Mailing address
4700 PARK GLEN RD, ST LOUIS PARK, MN 55416-5701
(952) 922-4200
(952) 922-4301
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1056
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
485010600
—
MN
Enumeration date
01/16/2007
Last updated
03/10/2016
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