Executive Mews Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD063137L Issued in PA

Legal business name

EXECUTIVE MEWS PEDIATRICS, LLC

Practice address

2300 Computer Ave
Suite H-44
Willow Grove, PA 19090-1742

Phone

(215) 830-8870

NPI assigned

Jul 25, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maria Mahoney, MD

Title

Owner/Physician

Phone

(215) 830-8870

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1437405602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 COMPUTER AVE",
            "address_2": "SUITE H-44",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901742",
            "telephone_number": "215-830-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 COMPUTER AVE",
            "address_2": "SUITE H-44",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901742",
            "telephone_number": "215-830-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEWS PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "215-830-8870",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD063137L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017043070004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.