Provider Demographics
NPI:1194722306
Name:WHITE OAK PEDIATRICS, DRS. BATTIATA & IMPEDUGLIA, P.A.
Entity type:Organization
Organization Name:WHITE OAK PEDIATRICS, DRS. BATTIATA & IMPEDUGLIA, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-635-0992
Mailing Address - Street 1:903 RUSSELL AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3257
Mailing Address - Country:US
Mailing Address - Phone:301-869-2292
Mailing Address - Fax:877-673-1105
Practice Address - Street 1:903 RUSSELL AVE
Practice Address - Street 2:STE 301
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3257
Practice Address - Country:US
Practice Address - Phone:301-869-2292
Practice Address - Fax:877-673-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD003342208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty