STC PEDIATRICS LLC (NPI# 1720623200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720623200 |
| Entity Type | Organization |
| Organization Name | STC PEDIATRICS LLC |
| Practice Address |
3401 N Broad St Philadelphia PA 19140-5103 |
| Mailing Address |
Po Box 13579 Reading PA 19612-3579 |
| Practice Telephone | 6107436049 |
| Mailing Telephone | 6107436049 |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2019-11-08 |
| Authorized Official Name | GARY CONNER (VP & CFO) |
| Authorized Official Telephone | 4846288181 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St. Christopher's Pediatric Associates Neonatology - N. Broad St. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516279 | Stc Pediatrics LLC | Pediatrics | 3601 A St Fl Family, Philadelphia, PA 19134-1043 | 2020-07-23 |
| 1932722881 | Stc Pediatrics LLC | Orthopaedic Surgery | 301 S 7th Ave Ste 3120, West Reading, PA 19611-1495 | 2020-05-27 |
| 1649806217 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave Fl 3, Philadelphia, PA 19134-1011 | 2020-03-16 |
| 1033753439 | Stc Pediatrics LLC | Pediatrics | 500 York Rd Ste 250, Jenkintown, PA 19046-2870 | 2019-10-30 |
| 1861036279 | Stc Pediatrics LLC | Pediatrics | 300 E Hunting Park Ave, Philadelphia, PA 19124-6018 | 2019-10-30 |
| 1639713944 | Stc Pediatrics LLC | Pediatrics | 1201 Langhorne Newtown Rd Ste 401, Langhorne, PA 19047-1201 | 2019-10-30 |
| 1548804909 | Stc Pediatrics LLC | Psychiatry & Neurology | 100 Kings Way E Ste C, Sewell, NJ 08080-2238 | 2019-10-29 |
| 1962046474 | Stc Pediatrics LLC | Pediatrics | 301 Oxford Valley Rd Ste 1201, Yardley, PA 19067-7706 | 2019-10-29 |
| 1508466913 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2020-10-27 |
| 1548867476 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2020-10-05 |
| Street Address |
3401 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942205133 | Shefali Agrawal | Specialist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2005-06-15 |
| 1962018523 | Caroline Grace Kelly | Audiologist | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-09-18 |
| 1457965964 | Barbara Ohiaeri | Pharmacist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-09-02 |
| 1710505904 | Cara Greenspan | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-14 | |
| 1013535756 | Srinivasa Prasad Venkata Kanuparthi | Neurological Surgery | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1417575143 | Sakshi Gandhi | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1801414594 | Azka Rahman | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-08 |
| 1417574658 | Anna-kaye Marie Brown | Anesthesiology | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-04 |
| 1285251405 | Shalonda Cook | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| 1386261501 | Temidayo Aderibigbe | Orthopaedic Surgery | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568656981 | Mario Zichella Jr. | Pediatrics | 1025 Walnut Street, Suite 700, Philadelphia, PA 19107-3121 | 2007-08-29 |
| 1235333774 | Andrea Freeman Duncan | Pediatrics | 3401 Civic Center Blvd Fl 2, Philadelphia, PA 19104-4319 | 2007-06-11 |
| 1831302603 | Folasade Ibironke Kehinde | Pediatrics | 160 E Erie Ave Dept Of, Philadelphia, PA 19134-1011 | 2007-05-08 |
| 1639204225 | Kirstie R Marcello | Pediatrics | 111 South 11th Street, 7th Floor College Building, Philadelphia, PA 19107 | 2007-02-22 |
| 1134286677 | Yanick Mary Vibert | Pediatrics | 230 North Broad Street, Mailstop 492, 10th Floor South Tower Neonatology Office, Philadelphia, PA 19102 | 2007-01-03 |
| 1164476842 | Karen Fritz | Pediatrics | St. Christopher's Hospital Erie Ave and Front St, Div of Neonatology, Philadelphia, PA 19131 | 2006-05-19 |
| 1043274376 | Daniel Henry Conway | Pediatrics | Front St and Erie Ave, St. Christopher's Hospital for Children, Philadelphia, PA 19134 | 2006-04-13 |
| 1639713076 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-29 |
| 1750863619 | Temple Faculty Practice Plan, Inc | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| 1659803526 | Oluwatobi Adegboyega | Pediatrics | 833 Chestnut St Ste 1210, Philadelphia, PA 19107-4428 | 2017-03-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.