Organization

Pediatric & Preventive Medicine Assoc Pc

Pediatrics Physician in Philadelphia, PA(View on Map)

Legal Business Name

Pediatric & Preventive Medicine Assoc Pc

NPI Number

1447311576

NPI Type

Organization

Enumeration Date

12/13/2006

Specialties

(Taxonomies)

Code

208000000X

Primary Taxonomy

Yes

Licenses

State

Pennsylvania

License Number

MD039729L

Contact
Information

Purpose

Mailing
Location

Address

3847 NORTH SYDENHAM STREET
4035 POWELTON AVE

City

Philadelphia
Philadelphia

State

PA
PA

Postal Code

19140
19104-2262

Country

US
US

Telephone Number

(215) 227-3300
(215) 471-7000

Authorized Official

Name

Randall Drain

Title or Position

PRESIDENT OWNER

Telephone Number

(215) 227-3300

Identifiers

Identifier

1054660

Identifier State

PA

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/11/2016

Provider Address

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Organization

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Organization

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Organization

St.Chris Care At Northeast Pediatrics, Llc

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Organization

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