| Organization Name: | PEDIATRIA HEALTHCARE, LLC |
| NPI Number: | 1548557879 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH D. SANSONE (CEO & PRESIDENT) |
| Mailing Address: | 8101 Washington Ln Suite 102 Wyncote |
| State: | PA US |
| Postal Code: | 190951625 |
| Phone Number: | 2153766801 |
| Fax Number: | 2153766805 |
| NPI Enumeration Date: | 07/07/2011 |
| NPI Last Update Date: | 07/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM3000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Medically Fragile Intants and Children Day Care |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). |