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General NPI Number Information
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NPI Number | 1699466409
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Entity Type | Organization
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Legal Business Name | BEDFORD PEDIATRICS
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 41 NORTH RD STE 200
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City | BEDFORD
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State | MA
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Zip | 01730-1037
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Country | US
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Telephone | 781-275-5437
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Fax | 781-275-6212
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Provider Business Mailing Address
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Address Line | 41 NORTH RD STE 200
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City | BEDFORD
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State | MA
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Zip | 01730-1037
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Country | US
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Telephone | 781-275-5437
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Fax | 781-275-6212
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Authorized Official
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Title or Position | PRINCIPAL OWNER
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Name | DAVID S GELLER
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Credential | MD
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Telephone | 781-275-5437
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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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