Basic Information
| Provider Information | |||||||||
| NPI: | 1932157765 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEIGHBORHOOD PEDIATRICS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2200 | ||||||||
| Address2: | |||||||||
| City: | AMHERST | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030314200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036739411 | ||||||||
| FaxNumber: | 6036739899 | ||||||||
| Practice Location | |||||||||
| Address1: | 881 SOUTH ST | ||||||||
| Address2: | |||||||||
| City: | FITCHBURG | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014206252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783424437 | ||||||||
| FaxNumber: | 9783436572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 03/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | KAROS | ||||||||
| AuthorizedOfficialFirstName: | DARIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9783424437 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | M18762 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 45662 | 01 | MA | NETWORK HEALTH | OTHER | 699952 | 01 | TUFTS HEALTH PLAN | OTHER | 90401 | 01 | MA | FALLON COMMUNITY HEALTH | OTHER | 9732420 | 05 | MA | MEDICAID |