Provider Demographics
NPI:1750510764
Name:EXPERIENCED PEDIATRICS
Entity Type:Organization
Organization Name:EXPERIENCED PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-578-0196
Mailing Address - Street 1:PO BOX 7558
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-0712
Mailing Address - Country:US
Mailing Address - Phone:347-578-0196
Mailing Address - Fax:
Practice Address - Street 1:100 MELROSE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6257
Practice Address - Country:US
Practice Address - Phone:347-578-0196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-11
Last Update Date:2009-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care