Provider Demographics
NPI:1558371468
Name:NEXT STEP PEDIATRICS LLC
Entity Type:Organization
Organization Name:NEXT STEP PEDIATRICS LLC
Other - Org Name:JEFFRIES LG BUCCI MD LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:THAYER
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-296-2300
Mailing Address - Street 1:7600 OSLER DRIVE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-296-2300
Mailing Address - Fax:410-296-3444
Practice Address - Street 1:7600 OSLER DRIVE
Practice Address - Street 2:SUITE 311
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-296-2300
Practice Address - Fax:410-296-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054956208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH76035Medicare UPIN