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General NPI Number Information
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NPI Number | 1295856169
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Entity Type | Organization
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Legal Business Name | PERRY PEDIATRICS, P.C.
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 CENTRE DR
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City | NEW BLOOMFIELD
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State | PA
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Zip | 17068-9675
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Country | US
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Telephone | 717-582-2181
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Fax | 717-582-3434
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Provider Business Mailing Address
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Address Line | PO BOX 356
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City | NEW BLOOMFIELD
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State | PA
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Zip | 17068-0356
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Country | US
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Telephone | 717-582-2181
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Fax | 717-582-3434
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Authorized Official
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Title or Position | CEO
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Name | DR. BYUNG D. CHANG
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Credential | M.D.
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Telephone | 717-582-2181
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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 | MD038287L
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License Number State | PA
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