MEDICARE: ABC PEDIATRIC CARE LLC

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

General Provider Information

NPI Number	:	1356521470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC PEDIATRIC CARE LLC

Provider Business Mailing Address
First Line	:	3135 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1144
Country	:	US
Telephone Number	:	724-654-4118
Fax Number	:	724-657-2669

Provider Business Practice Location Address
First Line	:	3135 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1144
Country	:	US
Telephone Number	:	724-654-4118
Fax Number	:	724-657-2669

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DOINA ANTONESCU
Credential	:	MD
Telephone Number	:	724-654-4118

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	04/12/2012

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