Provider Demographics
NPI:1659671576
Name:ST. CHRIS CARE AT NORTHEAST PEDIATRICS
Entity Type:Organization
Organization Name:ST. CHRIS CARE AT NORTHEAST PEDIATRICS
Other - Org Name:ST. CHRIS CARE @ LITTLE BUCKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING CORRDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:LABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-399-2705
Mailing Address - Street 1:1205 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1219
Mailing Address - Country:US
Mailing Address - Phone:215-891-8322
Mailing Address - Fax:215-891-8324
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 401
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1219
Practice Address - Country:US
Practice Address - Phone:215-891-8322
Practice Address - Fax:215-891-8324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty