Healthcare Provider Details

I. General information

NPI: 1588694384
Provider Name (Legal Business Name): FRANKLIN STREET PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 FRANKLIN ST
JOHNSTOWN PA
15905
US

IV. Provider business mailing address

1141 FRANKLIN ST
JOHNSTOWN PA
15905
US

V. Phone/Fax

Practice location:
  • Phone: 814-536-8956
  • Fax: 814-539-6601
Mailing address:
  • Phone: 814-536-8956
  • Fax: 814-539-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LAWRENCE S ROSENBERG
Title or Position: OFFICE MANAGER
Credential: MD
Phone: 814-536-8956