Provider Demographics
NPI:1326140625
Name:RIDDLE HEALTHCARE ASSOCIATES
Entity Type:Organization
Organization Name:RIDDLE HEALTHCARE ASSOCIATES
Other - Org Name:RIDDLE PEDIATRIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-627-4495
Mailing Address - Street 1:1098 W BALTIMORE PIKE
Mailing Address - Street 2:SUITE #3401
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5139
Mailing Address - Country:US
Mailing Address - Phone:610-627-4490
Mailing Address - Fax:610-627-4477
Practice Address - Street 1:1098 W BALTIMORE PIKE
Practice Address - Street 2:SUITE #3401
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-627-4490
Practice Address - Fax:610-627-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty