Provider Demographics
NPI:1265013155
Name:STC PEDIATRICS LLC
Entity Type:Organization
Organization Name:STC PEDIATRICS LLC
Other - Org Name:ST. CHRISTOPHER'S PEDIATRIC ASSOCIATES ORTHOPEDICS - GRINGS HILL RD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP FINANCIAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EHINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-628-1324
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:484-628-1324
Mailing Address - Fax:484-334-7026
Practice Address - Street 1:1020 GRINGS HILL RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19608-8844
Practice Address - Country:US
Practice Address - Phone:484-628-1324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports MedicineGroup - Multi-Specialty