Provider Demographics
NPI:1952778920
Name:PEDS ON THE GO PLLC
Entity Type:Organization
Organization Name:PEDS ON THE GO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FILIPOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-991-7683
Mailing Address - Street 1:51474 ORO DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-2931
Mailing Address - Country:US
Mailing Address - Phone:586-991-7683
Mailing Address - Fax:586-991-7642
Practice Address - Street 1:51474 ORO DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-2931
Practice Address - Country:US
Practice Address - Phone:586-991-7683
Practice Address - Fax:586-991-7642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056871174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty