Provider Demographics
NPI:1922052067
Name:MEADOWBROOK PEDIATRICS
Entity Type:Organization
Organization Name:MEADOWBROOK PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VERA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRUMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-947-1447
Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8004
Mailing Address - Country:US
Mailing Address - Phone:215-947-1447
Mailing Address - Fax:215-947-2603
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 320
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8004
Practice Address - Country:US
Practice Address - Phone:215-947-1447
Practice Address - Fax:215-947-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty