Provider Demographics
NPI:1376201616
Name:DROZDOW CHILDREN'S HEALTHCARE SERVICES OF NEVADA, P.C.
Entity Type:Organization
Organization Name:DROZDOW CHILDREN'S HEALTHCARE SERVICES OF NEVADA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-237-4863
Mailing Address - Street 1:5565 CENTERVIEW DR STE 107
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:625 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2215
Practice Address - Country:US
Practice Address - Phone:775-331-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty