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NPI Code Detail

MEDICARE: PEDIATRIC ASSOCIATES OF WARREN

MEDICARE: PEDIATRIC ASSOCIATES OF WARREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician35-06-1915-KOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720035587
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC ASSOCIATES OF WARREN
Provider Business Mailing Address
First Line : 321 NILES CORTLAND RD NE
Second Line :
City : WARREN
State : OH
Zip : 44484-1974
Country : US
Telephone Number : 330-609-5588
Fax Number : 330-609-5740
Provider Business Practice Location Address
First Line : 321 NILES CORTLAND RD NE
Second Line :
City : WARREN
State : OH
Zip : 44484-1974
Country : US
Telephone Number : 330-609-5588
Fax Number : 330-609-5740
Authorized Official
Title or Position : PRESIDENT
Name : DR. PETE KONDOLIOS
Credential : M.D.
Telephone Number : 330-609-5588
Provider Enumeration Date : 05/27/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1184083032 — NICHOLAS PATRICK CIFERNO PMHNP-BC
Practice Location Address:
321 NILES CORTLAND RD NE
WARREN, OH
44484-1974
Practice Phone: 330-355-3234
Practice Fax:
1720050610 — DR. ZENOVIA KONDOLIOS M.D.
Practice Location Address:
321 NILES CORTLAND RD NE
WARREN, OH
44484-1974
Practice Phone: 330-609-5588
Practice Fax: 330-609-5740
1124091343 — DR. PETE E KONDOLIOS M.D.
Practice Location Address:
321 NILES CORTLAND RD NE
WARREN, OH
44484-1974
Practice Phone: 330-609-5588
Practice Fax: 330-609-5740
1275579153 — DR. OSCAR F STERLE M.D.
Practice Location Address:
321 NILES CORTLAND RD NE
WARREN, OH
44484-1974
Practice Phone: 330-856-9201
Practice Fax: 330-856-4059
1205960739 — ALISA KATRADIS CPNP
Practice Location Address:
321 NILES CORTLAND RD NE
WARREN, OH
44484-1974
Practice Phone: 330-609-5588
Practice Fax: 330-609-5740
1962523241 — HOWLAND ORTHOPEDIC CENTER, INC.
Practice Location Address:
321 NILES CORTLAND RD NE
WARREN, OH
44484-1974
Practice Phone: 330-856-9201
Practice Fax: 330-856-4059

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