Provider Demographics
NPI:1629082342
Name:NEUROPEDIATRIX PC INC
Entity Type:Organization
Organization Name:NEUROPEDIATRIX PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:774-901-5504
Mailing Address - Street 1:1563 FALL RIVER AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-3736
Mailing Address - Country:US
Mailing Address - Phone:774-901-5504
Mailing Address - Fax:774-901-5507
Practice Address - Street 1:1563 FALL RIVER AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-3736
Practice Address - Country:US
Practice Address - Phone:774-901-5504
Practice Address - Fax:774-901-5507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Single Specialty