MEDICARE: STC PEDIATRICS LLC

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
1	2080C0008X	Child Abuse Pediatrics Physician
2	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1861036279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STC PEDIATRICS LLC

Provider Business Mailing Address
First Line	:	PO BOX 13579
Second Line	:
City	:	READING
State	:	PA
Zip	:	19612-3579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E HUNTING PARK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-6018
Country	:	US
Telephone Number	:	215-427-5000
Fax Number	:

Authorized Official
Title or Position	:	VP OF REVENUE INTEGRITY
Name	:	CHARLES MICHAEL VALENTINO JR.
Credential	:
Telephone Number	:	484-628-9380

Provider Enumeration Date	:	10/30/2019
Last Update Date	:	06/02/2026

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Directions to “STC PEDIATRICS LLC ” Practice Location

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