Provider Demographics
NPI:1184766578
Name:PEDIATRICIANS, INC.
Entity type:Organization
Organization Name:PEDIATRICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ANNINO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:781-729-4262
Mailing Address - Street 1:955 MAIN ST
Mailing Address - Street 2:SUITE 103 & 106
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1961
Mailing Address - Country:US
Mailing Address - Phone:781-729-4262
Mailing Address - Fax:781-729-0692
Practice Address - Street 1:955 MAIN ST
Practice Address - Street 2:SUITE 103 & 106
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1961
Practice Address - Country:US
Practice Address - Phone:781-729-4262
Practice Address - Fax:781-729-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA701732OtherTUFTS HEALTH PLAN
MA9786708Medicaid
MAM10667OtherBLUECROSS & BLUESHIELD