MEDICARE: COLONIAL PARK PEDIATRICS ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033120365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLONIAL PARK PEDIATRICS ASSOCIATES

Provider Business Mailing Address
First Line	:	2205 FOREST HILLS DR
Second Line	:	SUITE 12
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1001
Country	:	US
Telephone Number	:	717-652-8001
Fax Number	:	717-540-9757

Provider Business Practice Location Address
First Line	:	2205 FOREST HILLS DR
Second Line	:	SUITE 12
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1001
Country	:	US
Telephone Number	:	717-652-8001
Fax Number	:	717-540-9757

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NEENA VARMA
Credential	:	MD
Telephone Number	:	717-652-8001

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	08/22/2020

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