Provider Demographics
NPI:1518652239
Name:PEDIATRIC DEVELOPMENTAL CONNECTIONS
Entity Type:Organization
Organization Name:PEDIATRIC DEVELOPMENTAL CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NILAM
Authorized Official - Middle Name:PATEL
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-751-7023
Mailing Address - Street 1:3281 E CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4509
Mailing Address - Country:US
Mailing Address - Phone:602-751-7023
Mailing Address - Fax:
Practice Address - Street 1:21805 S ELLSWORTH RD STE 111
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-9366
Practice Address - Country:US
Practice Address - Phone:480-462-3868
Practice Address - Fax:480-462-3868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Multi-Specialty