Provider Demographics
NPI:1033216544
Name:PATHWAY PEDIATRICS LLC
Entity Type:Organization
Organization Name:PATHWAY PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:ZANKEL
Authorized Official - Last Name:GLOWINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-256-2210
Mailing Address - Street 1:2225 SOUTH CLINTON AVENUE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2623
Mailing Address - Country:US
Mailing Address - Phone:585-256-2210
Mailing Address - Fax:585-256-2245
Practice Address - Street 1:2225 SOUTH CLINTON AVENUE
Practice Address - Street 2:SUITE 1A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2623
Practice Address - Country:US
Practice Address - Phone:585-256-2210
Practice Address - Fax:585-256-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty