Provider Demographics
NPI:1346202066
Name:TRI-COUNTY PEDIATRIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:TRI-COUNTY PEDIATRIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:RINGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-344-3791
Mailing Address - Street 1:907 SUMNER ST
Mailing Address - Street 2:SUITE M-102
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3374
Mailing Address - Country:US
Mailing Address - Phone:781-344-3791
Mailing Address - Fax:781-341-3614
Practice Address - Street 1:907 SUMNER ST
Practice Address - Street 2:SUITE M-102
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3374
Practice Address - Country:US
Practice Address - Phone:781-344-3791
Practice Address - Fax:781-341-3614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA97-39327Medicaid