Provider Demographics
NPI:1508351784
Name:CEDAR HILL PEDIATRICS LLC
Entity Type:Organization
Organization Name:CEDAR HILL PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-427-6000
Mailing Address - Street 1:1324 BELMONT ST STE 105
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4435
Mailing Address - Country:US
Mailing Address - Phone:508-427-6000
Mailing Address - Fax:508-427-6010
Practice Address - Street 1:1324 BELMONT ST STE 105
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4435
Practice Address - Country:US
Practice Address - Phone:508-427-6000
Practice Address - Fax:508-427-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217107208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty