Provider Demographics
NPI:1578990610
Name:LOWER BUCKS PEDIATRICS
Entity Type:Organization
Organization Name:LOWER BUCKS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-493-1750
Mailing Address - Street 1:1690 BIG OAK RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6421
Mailing Address - Country:US
Mailing Address - Phone:215-493-1750
Mailing Address - Fax:215-493-1470
Practice Address - Street 1:1690 BIG OAK RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-6421
Practice Address - Country:US
Practice Address - Phone:215-493-1750
Practice Address - Fax:215-493-1470
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWER BUCKS PEDIATRICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty