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General NPI Number Information
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NPI Number | 1932722881
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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 | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 301 S 7TH AVE STE 3120
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City | WEST READING
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State | PA
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Zip | 19611-1495
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Country | US
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Telephone | 484-628-0797
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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 | GARY CONNER
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Credential |
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Telephone | 484-628-0797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology 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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology 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 | 2080S0012X
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Taxonomy Name | Pediatric Sleep Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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License Number State |
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Taxonomy #6
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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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