Provider Demographics
NPI:1962752469
Name:PEDIATRIC PARTNERS FOR ATTENTION AND LEARNING, INC.
Entity type:Organization
Organization Name:PEDIATRIC PARTNERS FOR ATTENTION AND LEARNING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-300-2013
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-0094
Mailing Address - Country:US
Mailing Address - Phone:540-300-2013
Mailing Address - Fax:
Practice Address - Street 1:282 CHOPTANK ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-6481
Practice Address - Country:US
Practice Address - Phone:540-300-2013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242203208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty