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General NPI Number Information
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NPI Number | 1265328983
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Entity Type | Organization
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Legal Business Name | PM PEDIATRICS OF MARYLAND LLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 9613 HARFORD RD # STORE500
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City | PARKVILLE
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State | MD
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Zip | 21234-2150
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Country | US
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Telephone | 443-461-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HOLLOW LN STE 301
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1215
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Country | US
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Telephone | 516-207-7936
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Fax |
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Authorized Official
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Title or Position | DIRECTOR CREDETIALING/ENROLLMENT
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Name | MS. DANIELLE MARIE LOPEZ
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Credential |
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Telephone | 516-207-7936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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