Provider Demographics
NPI:1932283348
Name:PEDIATRIC ASSOCIATES LLP
Entity Type:Organization
Organization Name:PEDIATRIC ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PINKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-487-1541
Mailing Address - Street 1:601 NORTH WAY
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1498
Mailing Address - Country:US
Mailing Address - Phone:315-487-1541
Mailing Address - Fax:315-487-3485
Practice Address - Street 1:601 NORTH WAY
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-1498
Practice Address - Country:US
Practice Address - Phone:315-487-1541
Practice Address - Fax:315-487-3485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty