Provider Demographics
NPI:1164480901
Name:PEDIATRIC ASSOCIATES OF RICHMOND INC.
Entity Type:Organization
Organization Name:PEDIATRIC ASSOCIATES OF RICHMOND INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPERNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-288-3525
Mailing Address - Street 1:7113 THREE CHOPT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3643
Mailing Address - Country:US
Mailing Address - Phone:804-288-3525
Mailing Address - Fax:804-673-6432
Practice Address - Street 1:7113 THREE CHOPT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3643
Practice Address - Country:US
Practice Address - Phone:804-288-3525
Practice Address - Fax:804-673-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty