Provider Demographics
NPI:1396932687
Name:CHILDREN'S PEDIATRICIANS & ASSOCIATES, LLC
Entity type:Organization
Organization Name:CHILDREN'S PEDIATRICIANS & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JANOWIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:301-572-1382
Mailing Address - Street 1:12211 PLUM ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7903
Mailing Address - Country:US
Mailing Address - Phone:301-754-3040
Mailing Address - Fax:301-681-0789
Practice Address - Street 1:12211 PLUM ORCHARD DR STE 220
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7903
Practice Address - Country:US
Practice Address - Phone:301-754-3040
Practice Address - Fax:301-681-0789
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S NATIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-01
Last Update Date:2025-06-11
Deactivation Date:2025-02-03
Deactivation Code:
Reactivation Date:2025-02-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD258008002Medicaid