Provider Demographics
NPI:1932475951
Name:SCHOOLHOUSE PEDIATRICS SOUTH
Entity Type:Organization
Organization Name:SCHOOLHOUSE PEDIATRICS SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMAROTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-456-1211
Mailing Address - Street 1:11835 RT 9W
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WEST COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12192-3605
Mailing Address - Country:US
Mailing Address - Phone:518-731-3800
Mailing Address - Fax:518-731-3838
Practice Address - Street 1:81 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3834
Practice Address - Country:US
Practice Address - Phone:518-456-1211
Practice Address - Fax:518-452-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty