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General NPI Number Information
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NPI Number | 1427945468
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Entity Type | Organization
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Legal Business Name | PEDIATRIX MEDICAL GROUP OF PENNSYLVANIA, P.C.
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 300 HIGHLAND AVE
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City | HANOVER
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State | PA
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Zip | 17331-2297
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Country | US
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Telephone | 717-316-3711
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100445
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City | ATLANTA
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State | GA
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Zip | 30384-0445
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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 | ASSISTANT SECRETARY
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Name | NICHOLAS GLASER
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Credential |
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Telephone | 954-384-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine 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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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