Provider Demographics
NPI:1326785551
Name:HEALTHY KIDZ
Entity Type:Organization
Organization Name:HEALTHY KIDZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:POORNIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-891-9127
Mailing Address - Street 1:1005 ROYAL FERN CT
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-0285
Mailing Address - Country:US
Mailing Address - Phone:573-891-9127
Mailing Address - Fax:
Practice Address - Street 1:10410 PARK RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-6568
Practice Address - Country:US
Practice Address - Phone:573-891-9127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty