Provider Demographics
NPI:1053921627
Name:ACORN PEDIATRICS, INC
Entity type:Organization
Organization Name:ACORN PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:IWASHYNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-548-4700
Mailing Address - Street 1:13207 HOLLYHOCK CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7534
Mailing Address - Country:US
Mailing Address - Phone:804-475-2637
Mailing Address - Fax:
Practice Address - Street 1:2610-B GASKINS ROAD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238
Practice Address - Country:US
Practice Address - Phone:804-548-4700
Practice Address - Fax:804-548-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty