Provider Demographics
NPI:1578586582
Name:NORTHAMPTON AREA PEDIATRICS, LLP
Entity Type:Organization
Organization Name:NORTHAMPTON AREA PEDIATRICS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:KENNY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-584-8700
Mailing Address - Street 1:193 LOCUST ST
Mailing Address - Street 2:#2
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2066
Mailing Address - Country:US
Mailing Address - Phone:413-584-8700
Mailing Address - Fax:413-584-1714
Practice Address - Street 1:193 LOCUST ST
Practice Address - Street 2:#2
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2066
Practice Address - Country:US
Practice Address - Phone:413-584-8700
Practice Address - Fax:413-584-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9773126Medicaid
MA9773126Medicaid