Provider Demographics
NPI:1346456282
Name:NATICK PEDIATRICS PC
Entity Type:Organization
Organization Name:NATICK PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:LINDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:508-820-9699
Mailing Address - Street 1:61 LINCOLN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8264
Mailing Address - Country:US
Mailing Address - Phone:508-820-9699
Mailing Address - Fax:508-820-2984
Practice Address - Street 1:61 LINCOLN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8264
Practice Address - Country:US
Practice Address - Phone:508-820-9699
Practice Address - Fax:508-820-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204186208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9720260Medicaid
MAH15120Medicare UPIN