1201 Pediatric Group

NPI #1083694798 in Bryn Mawr, Pennsylvania

Provider Information

NPI Number: 1083694798
Entity Type: Organization
Organization Name: 1201 Pediatric Group
Primary Specialty: Pediatrics
Enumeration Date: Jan 19, 2006
Last Updated: Jul 18, 2008

Practice Location

Address: 1201 COUNTY LINE RD
Address 2: SUITE 200
City: Bryn Mawr
State: Pennsylvania
ZIP Code: 19010-2636
Phone: (610) 525-2180

Authorized Official

Name: JEFFERY BOMZE, MD
Title: PRESIDENT
Phone: (610) 525-2180

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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