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General NPI Number Information
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NPI Number | 1285278416
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Entity Type | Organization
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Legal Business Name | STC PEDIATRICS LLC
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 160 E ERIE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1011
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Country | US
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Telephone | 215-427-3131
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13579
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City | READING
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State | PA
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Zip | 19612-3579
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EVP & CFO
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Name | BRIAN RAYME
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Credential |
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Telephone | 484-628-1324
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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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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number |
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License Number State |
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