Healthcare Provider Details

I. General information

NPI: 1124970702
Provider Name (Legal Business Name): LIVINGSTON PEDIATRIC CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 KISSANE AVE
BRIGHTON MI
48116-2467
US

IV. Provider business mailing address

136 KISSANE AVE
BRIGHTON MI
48116-2467
US

V. Phone/Fax

Practice location:
  • Phone: 810-229-7337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: BIPIN DESAI
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 517-304-4871