Provider Demographics
NPI:1629946751
Name:PEDIATRIC COLLECTIVE LLC
Entity type:Organization
Organization Name:PEDIATRIC COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-814-0711
Mailing Address - Street 1:6675 S TENAYA WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1932
Mailing Address - Country:US
Mailing Address - Phone:702-814-0711
Mailing Address - Fax:702-745-1972
Practice Address - Street 1:6675 S TENAYA WAY STE 200
Practice Address - Street 2:SUITE 200 OFFICE 18
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1932
Practice Address - Country:US
Practice Address - Phone:702-814-0711
Practice Address - Fax:702-745-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty