Provider Demographics
NPI:1750444832
Name:OBERLIN PEDIATRICS INC
Entity Type:Organization
Organization Name:OBERLIN PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:DOMBROSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-774-7337
Mailing Address - Street 1:224 WEST LORAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:OBERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44074
Mailing Address - Country:US
Mailing Address - Phone:440-774-7337
Mailing Address - Fax:440-774-7327
Practice Address - Street 1:224 WEST LORAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074
Practice Address - Country:US
Practice Address - Phone:440-774-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty