Provider Demographics
NPI:1679724884
Name:NEIGHBORHOOD PEDIATRICS, LLC
Entity type:Organization
Organization Name:NEIGHBORHOOD PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:MILOVANOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-221-5901
Mailing Address - Street 1:14701 DETROIT AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4115
Mailing Address - Country:US
Mailing Address - Phone:216-221-5901
Mailing Address - Fax:216-221-5881
Practice Address - Street 1:14701 DETROIT AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4115
Practice Address - Country:US
Practice Address - Phone:216-221-5901
Practice Address - Fax:216-221-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057882261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care