Provider Demographics
NPI:1063482610
Name:WHITE OAK PEDIATRICS DR BATTIATA & IMPEDUGLIA PA
Entity type:Organization
Organization Name:WHITE OAK PEDIATRICS DR BATTIATA & IMPEDUGLIA PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR PEDIATRIC PLACE UN
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:NIEMEYER
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-360-4446
Mailing Address - Street 1:11161 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:410-360-4446
Mailing Address - Fax:410-360-4449
Practice Address - Street 1:3100 MOUNTAIN RD
Practice Address - Street 2:SUITE E
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122
Practice Address - Country:US
Practice Address - Phone:410-360-4446
Practice Address - Fax:410-360-4449
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITE OAK PEDIATRICS DRS BATTIATA & IMPEDUGLIA PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-25
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD111071300Medicaid
MD952601300Medicaid
MD880008100Medicaid
MD907009500Medicaid
MD88056600Medicaid
MD670038100Medicaid
MD763500100Medicaid