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General NPI Number Information
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NPI Number | 1174836621
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Entity Type | Organization
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Legal Business Name | SCHC PEDIATRIC ASSOCIATES, LLC
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 3601 A STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1095
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Country | US
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Telephone | 215-427-8881
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Fax | 215-427-4494
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Provider Business Mailing Address
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Address Line | 3601 A STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1095
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Country | US
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Telephone | 215-427-8881
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Fax | 215-427-4494
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Authorized Official
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Title or Position | CEO
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Name | BERNADETTE M MANGAN
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Credential |
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Telephone | 215-427-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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