Provider Demographics
NPI:1033292420
Name:PEDIATRIC & ADOLESCENT CARE OF SILVER SPRING, P.A.
Entity type:Organization
Organization Name:PEDIATRIC & ADOLESCENT CARE OF SILVER SPRING, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-681-6730
Mailing Address - Street 1:344 UNIVERSITY BLVD W STE 112
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1969
Mailing Address - Country:US
Mailing Address - Phone:301-681-6730
Mailing Address - Fax:301-681-4268
Practice Address - Street 1:344 UNIVERSITY BLVD W STE 112
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1969
Practice Address - Country:US
Practice Address - Phone:301-681-6730
Practice Address - Fax:301-681-4268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5666OtherBC/BS NCA