Provider Demographics
NPI:1285096719
Name:KIDSWELL PEDIATRICS & URGENT CARE PC
Entity type:Organization
Organization Name:KIDSWELL PEDIATRICS & URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU-LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-340-8899
Mailing Address - Street 1:299 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1612
Mailing Address - Country:US
Mailing Address - Phone:617-340-8899
Mailing Address - Fax:617-916-0893
Practice Address - Street 1:299 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1612
Practice Address - Country:US
Practice Address - Phone:617-340-8899
Practice Address - Fax:617-916-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222689261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care