Provider Demographics
NPI:1194037150
Name:PEDIATRIC CENTER OF CANTON, LLC
Entity Type:Organization
Organization Name:PEDIATRIC CENTER OF CANTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:NEELAM
Authorized Official - Middle Name:GROVER
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-456-9939
Mailing Address - Street 1:1445 HARRISON AVE. NW
Mailing Address - Street 2:SUITE 300 & 306
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708
Mailing Address - Country:US
Mailing Address - Phone:330-456-9939
Mailing Address - Fax:330-456-3212
Practice Address - Street 1:1445 HARRISON AVE. NW
Practice Address - Street 2:SUITE 300 & 306
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708
Practice Address - Country:US
Practice Address - Phone:330-456-9939
Practice Address - Fax:330-456-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.047428208000000X
OH34.008837208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty