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General NPI Number Information
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NPI Number | 1225942410
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Entity Type | Organization
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Legal Business Name | PARK PEDIATRICS
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 13976 BALTIMORE AVE
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City | LAUREL
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State | MD
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Zip | 20707-5086
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Country | US
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Telephone | 301-891-6141
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Fax |
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Provider Business Mailing Address
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Address Line | 7610 CARROLL AVE STE 400
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City | TAKOMA PARK
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State | MD
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Zip | 20912-6321
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Country | US
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Telephone | 301-891-6141
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CECILIA BYRNES
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Credential |
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Telephone | 301-891-6141
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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 | NULL
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