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1982830873 NPI number — PENGUIN PEDIATRICS

NPI Number: 1982830873
Health Care Provider/Practitioner: PENGUIN PEDIATRICS

Information about “1982830873” NPI (PENGUIN PEDIATRICS) exists in 1982830873 in HTML format HTML  |  1982830873 in plain Text format TXT  |  1982830873 in PDF (Portable Document Format) PDF  |  1982830873 in an XML format XML  formats.

NPI Number : 1982830873 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982830873",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PENGUIN PEDIATRICS",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "44081 PIPELINE PLZ",
    "SecondLineMailingAddress": "#125",
    "MailingAddressCityName": "ASHBURN",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "20147-5891",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "571-223-2229",
    "MailingAddressFaxNumber": "571-223-3299",
    "FirstLinePracticeLocationAddress": "44081 PIPELINE PLZ",
    "SecondLinePracticeLocationAddress": "#125",
    "PracticeLocationAddressCityName": "ASHBURN",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "20147-5891",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "571-223-2229",
    "PracticeLocationAddressFaxNumber": "571-223-3299",
    "EnumerationDate": "06/05/2009",
    "LastUpdateDate": "06/05/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KODU",
    "AuthorizedOfficialFirstName": "UMESH",
    "AuthorizedOfficialMiddleName": "VENKATA",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "571-223-2229",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "0101243313",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "0101034278",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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