Provider Demographics
NPI:1134777048
Name:PEDIATRIC ASSOCIATES OF NEW BEDFORD, INC
Entity type:Organization
Organization Name:PEDIATRIC ASSOCIATES OF NEW BEDFORD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-999-2981
Mailing Address - Street 1:225 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2134
Mailing Address - Country:US
Mailing Address - Phone:508-999-2981
Mailing Address - Fax:508-910-3395
Practice Address - Street 1:225 FIELD ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2134
Practice Address - Country:US
Practice Address - Phone:508-999-2981
Practice Address - Fax:508-910-3395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty