South Suburban Pediatrics
Pediatrics in Quincy, MA. Organization (NPI-2).
NPI number1760680987
StatusActive
Last updated in NPPESJul 10, 2007
Details
- NPI
- 1760680987
- Entity type
- Organization (NPI-2)
- Legal business name
- South Suburban Pediatrics
- Organization subpart
- No
- Enumeration date
- Jul 10, 2007
- Last updated
- Jul 10, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 54474 | MA | Yes |
Practice location
101 Adams StreetQuincy, MA 02169
Phone 617-773-7754 · Fax 617-328-0957
Mailing address
101 Adams StreetQuincy, MA 02169
Phone 617-773-7754 · Fax 617-328-0957
Authorized official
George Hom
President
6177737754
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