Provider Demographics
NPI:1942436100
Name:PEDIATRIC PARTNERS, LLC
Entity type:Organization
Organization Name:PEDIATRIC PARTNERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:CSEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-595-2184
Mailing Address - Street 1:PO BOX 3457
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-3457
Mailing Address - Country:US
Mailing Address - Phone:847-265-1460
Mailing Address - Fax:
Practice Address - Street 1:12600 N 113TH AVE
Practice Address - Street 2:BUILDING A
Practice Address - City:YOUNGTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85363-1162
Practice Address - Country:US
Practice Address - Phone:480-595-2184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty