Provider Demographics
NPI:1144433236
Name:SHOREVIEW PEDIATRICS, S.C.
Entity type:Organization
Organization Name:SHOREVIEW PEDIATRICS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ONINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-272-7009
Mailing Address - Street 1:2524 E WEBSTER PL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4256
Mailing Address - Country:US
Mailing Address - Phone:414-272-7009
Mailing Address - Fax:414-272-6261
Practice Address - Street 1:2524 E WEBSTER PL
Practice Address - Street 2:SUITE 301
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4256
Practice Address - Country:US
Practice Address - Phone:414-272-7009
Practice Address - Fax:414-272-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty