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General NPI Number Information
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NPI Number | 1063419943
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ACADEMIC ASSOCIATION, INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 700 CHILDRENS DR
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City | COLUMBUS
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State | OH
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Zip | 43205-2664
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Country | US
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Telephone | 614-722-4579
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Fax | 614-722-4565
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Provider Business Mailing Address
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Address Line | 700 CHILDRENS DR
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City | COLUMBUS
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State | OH
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Zip | 43205-2664
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Country | US
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Telephone | 614-722-2000
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Fax | 614-355-4497
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CATHERINE KRAWCZESKI
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Credential | MD
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Telephone | 614-722-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | OH
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