Provider Demographics
NPI:1477935716
Name:UPPER VALLEY PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:UPPER VALLEY PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O./PRACTICE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:YUKICA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:802-222-4722
Mailing Address - Street 1:331 UPPER PLN
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05033-9207
Mailing Address - Country:US
Mailing Address - Phone:802-222-4722
Mailing Address - Fax:802-222-4709
Practice Address - Street 1:331 UPPER PLN
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:VT
Practice Address - Zip Code:05033-9207
Practice Address - Country:US
Practice Address - Phone:802-222-4722
Practice Address - Fax:802-222-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-23
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty