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Contact Information

PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C.
3640 MAIN ST
SUITE 204
SPRINGFIELD, MA01107-1145
 Phone: 413-304-2650
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C.

NPI # 1164733093
LBN Legal business name PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C.
Authorized official SUSAN GOODE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/25/2010
Last updated 06/25/2010 - About 16 years ago
Identifiers
MA License # 233855
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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