Provider Demographics
NPI:1033715503
Name:BAYSIDE PEDIATRICS PC
Entity Type:Organization
Organization Name:BAYSIDE PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:413-733-6595
Mailing Address - Street 1:84 CHAPIN TER
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1706
Mailing Address - Country:US
Mailing Address - Phone:413-733-6595
Mailing Address - Fax:413-733-4544
Practice Address - Street 1:84 CHAPIN TER
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1706
Practice Address - Country:US
Practice Address - Phone:413-733-6595
Practice Address - Fax:413-733-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty