Provider Demographics
NPI:1467855254
Name:KIDS AND TEENS PEDIATRICS OF DOVER
Entity Type:Organization
Organization Name:KIDS AND TEENS PEDIATRICS OF DOVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-538-5624
Mailing Address - Street 1:938 S BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4140
Mailing Address - Country:US
Mailing Address - Phone:302-538-5624
Mailing Address - Fax:
Practice Address - Street 1:938 S BRADFORD ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4140
Practice Address - Country:US
Practice Address - Phone:302-538-5624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty