Provider Demographics
NPI:1942671441
Name:MARGIOTTI & KROLL PEDIATRICS, PC
Entity Type:Organization
Organization Name:MARGIOTTI & KROLL PEDIATRICS, PC
Other - Org Name:MK PLUS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-968-5800
Mailing Address - Street 1:31 CAMBRIDGE LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-968-5151
Mailing Address - Fax:215-968-5252
Practice Address - Street 1:31 CAMBRIDGE LANE
Practice Address - Street 2:SUITE A
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-968-5151
Practice Address - Fax:215-968-5252
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARGIOTTI & KROLL PEDIATRICS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-12
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103T00000X, 2084B0040X, 2084P0800X, 235Z00000X
133VN1004X, 174N00000X, 2251P0200X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty