Provider Demographics
NPI:1992768782
Name:PARKVIEW PEDIATRICS, PLLC
Entity type:Organization
Organization Name:PARKVIEW PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-383-1160
Mailing Address - Street 1:1050 PITTSFORD VICTOR RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3812
Mailing Address - Country:US
Mailing Address - Phone:585-383-1160
Mailing Address - Fax:585-383-8945
Practice Address - Street 1:1050 PITTSFORD VICTOR RD
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3812
Practice Address - Country:US
Practice Address - Phone:585-383-1160
Practice Address - Fax:585-383-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG0185033590OtherEXCELLUS MANAGED CARE