Provider Demographics
NPI:1710958178
Name:NORTH WILLOW GROVE PEDIATRICS, PC
Entity Type:Organization
Organization Name:NORTH WILLOW GROVE PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CIROTTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-672-6622
Mailing Address - Street 1:2510 MARYLAND RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1109
Mailing Address - Country:US
Mailing Address - Phone:215-672-6622
Mailing Address - Fax:215-672-6566
Practice Address - Street 1:2510 MARYLAND RD
Practice Address - Street 2:SUITE 160
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1109
Practice Address - Country:US
Practice Address - Phone:215-672-6622
Practice Address - Fax:215-672-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty