Provider Demographics
NPI:1104942622
Name:KIDDOCS, P.A.
Entity type:Organization
Organization Name:KIDDOCS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EPHIGENIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GIANNOUKOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-892-3300
Mailing Address - Street 1:4600 NEW LINDEN HILL RD
Mailing Address - Street 2:BROWNSTONE PLAZA, SUITE 204
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2953
Mailing Address - Country:US
Mailing Address - Phone:302-892-3300
Mailing Address - Fax:302-892-9824
Practice Address - Street 1:4600 NEW LINDEN HILL RD
Practice Address - Street 2:BROWNSTONE PLAZA, SUITE 204
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2953
Practice Address - Country:US
Practice Address - Phone:302-892-3300
Practice Address - Fax:302-892-9824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003971208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty