Provider Demographics
NPI:1518080795
Name:FITCHBURG PEDIATRICS, P.C.
Entity Type:Organization
Organization Name:FITCHBURG PEDIATRICS, P.C.
Other - Org Name:FITCHBURG PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-345-7172
Mailing Address - Street 1:881 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-6252
Mailing Address - Country:US
Mailing Address - Phone:978-345-7172
Mailing Address - Fax:978-348-2549
Practice Address - Street 1:881 SOUTH ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-6252
Practice Address - Country:US
Practice Address - Phone:978-345-7172
Practice Address - Fax:978-348-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41802174400000X
174400000X, 208000000X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9728040Medicaid
MAE02051Medicare UPIN