Provider Demographics
NPI:1952315822
Name:WAYNE PEDIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:WAYNE PEDIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOOREVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-293-2229
Mailing Address - Street 1:110 W LANCASTER AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4043
Mailing Address - Country:US
Mailing Address - Phone:610-293-2229
Mailing Address - Fax:610-293-2231
Practice Address - Street 1:110 W LANCASTER AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4043
Practice Address - Country:US
Practice Address - Phone:610-293-2229
Practice Address - Fax:610-293-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care