Healthcare Provider Details

I. General information

NPI: 1821813403
Provider Name (Legal Business Name): PEDIATRIX MEDICAL GROUP OF PENNSYLVANIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 06/22/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD
MONROEVILLE PA
15146-3513
US

IV. Provider business mailing address

PO BOX 100445
ATLANTA GA
30384-0445
US

V. Phone/Fax

Practice location:
  • Phone: 412-858-2000
  • Fax:
Mailing address:
  • Phone: 800-243-3839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS E GLASER
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 954-384-0175