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NPI Code Detail

MEDICARE: CHILDREN MAKING STRIDES

MEDICARE: CHILDREN MAKING STRIDES
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
12080P0006XDevelopmental - Behavioral Pediatrics Physician

General Provider Information

NPI Number : 1588197958
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN MAKING STRIDES
Provider Business Mailing Address
First Line : 6 RESNIK RD STE 210
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-5379
Country : US
Telephone Number : 508-563-5767
Fax Number :
Provider Business Practice Location Address
First Line : 6 RESNIK RD STE 210
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-5379
Country : US
Telephone Number : 508-563-5767
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : CHAIM FISKUS
Credential :
Telephone Number : 508-563-5767
Provider Enumeration Date : 04/04/2017
Last Update Date : 08/10/2023

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Directions to “CHILDREN MAKING STRIDES ” Practice Location

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