Provider Demographics
NPI:1518046739
Name:FRAMINGHAM PEDIATRICS, PC
Entity Type:Organization
Organization Name:FRAMINGHAM PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANDELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-879-5764
Mailing Address - Street 1:125 NEWBURY ST
Mailing Address - Street 2:SUITE300
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4592
Mailing Address - Country:US
Mailing Address - Phone:508-879-5764
Mailing Address - Fax:508-820-0864
Practice Address - Street 1:125 NEWBURY ST
Practice Address - Street 2:SUITE300
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4592
Practice Address - Country:US
Practice Address - Phone:508-879-5764
Practice Address - Fax:508-820-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9768912Medicaid