QUINCY PEDIATRIC ASSOCIATES INC NPI 1063582781

NPI Information

  • NPI: 1063582781
  • Provider Name: QUINCY PEDIATRIC ASSOCIATES INC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 22D0078249
  • Address: 191 INDEPENDENCE AVE
    QUINCY, MA
    ZIP 02169
  • Phone: (617) 773-5070

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NPI Details

QUINCY PEDIATRIC ASSOCIATES INC is a pediatrics in Quincy, MA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. QUINCY PEDIATRIC ASSOCIATES INC NPI is 1063582781. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

191 INDEPENDENCE AVE
QUINCY, MA
ZIP 02169-751
Phone: (617) 773-5070

The provider's authorized official is Roberta Broderick .
The authorized official title is Practice Manager and has the following contact phone number (781) 837-4044.

The CLIA number assigned to this NPI record is 22D0078249 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/9/2006 and was last updated on 5/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics208000000XMASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1552112OTHERMASSACHUSETTSUNITED HEALTH CARE
2M10943OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
39101OTHERMASSACHUSETTSAETNA
49700919MEDICAIDMASSACHUSETTS
5600012BOTHERMASSACHUSETTSTUFTS HEALTH PLAN
6601040OTHERMASSACHUSETTSHARVARD PILGRIM HEALTH CA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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