Provider Demographics
NPI:1457348278
Name:PIZZICA PEDIATRICS LLC
Entity Type:Organization
Organization Name:PIZZICA PEDIATRICS LLC
Other - Org Name:PIZZICA PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIZZICA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-735-4519
Mailing Address - Street 1:100 E LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1012
Mailing Address - Country:US
Mailing Address - Phone:215-707-1059
Mailing Address - Fax:215-707-1049
Practice Address - Street 1:100 E LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1000
Practice Address - Country:US
Practice Address - Phone:215-707-1059
Practice Address - Fax:215-707-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty