National Provider Identifier Database

PROVIDENCE PEDIATRICS PC
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

PROVIDENCE PEDIATRICS, PC
338 RUSSELL AVENUE
WILLIAMSPORT, PA17701
Phone: 570-326-5720
Fax: 570-601-1522
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X
Adolescent Medicine 2080A0000X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE PEDIATRICS, PC

NPI Number 1265575955
Legal business name
LBN
PROVIDENCE PEDIATRICS, PC
Authorized official JOSEPH DEMAY - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 02/14/2007
Last updated 01/11/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: MD046306-L
  • PA License #: MD046306L
  • PA Medicaid: 0012712310004

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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