Provider Demographics
NPI:1750108031
Name:PEDIATRIC PARTNERS LLC
Entity type:Organization
Organization Name:PEDIATRIC PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISSY
Authorized Official - Middle Name:L
Authorized Official - Last Name:OFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-638-0537
Mailing Address - Street 1:4C NORTH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2333
Mailing Address - Country:US
Mailing Address - Phone:410-638-0537
Mailing Address - Fax:240-383-3516
Practice Address - Street 1:8600 LASALLE AVENUE
Practice Address - Street 2:POTOMAC BUILDING SUITE 105
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-823-5232
Practice Address - Fax:410-296-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty