Pennsylvania Diversity Children's Organization, Inc

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

PENNSYLVANIA DIVERSITY CHILDREN'S ORGANIZATION, INC

Practice address

2337 Philmont Ave
Suite 106
Huntingdon Valley, PA 19006-6200

Phone

(267) 571-2469

Fax

(267) 571-2476

NPI assigned

May 3, 2013

Last updated

Aug 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Tetyana Varenychenko

Title

Executive Director

Phone

(267) 571-2469

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1447695432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2337 PHILMONT AVE",
            "address_2": "SUITE 106",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066200",
            "telephone_number": "267-571-2469",
            "fax_number": "267-571-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2337 PHILMONT AVE",
            "address_2": "SUITE 106",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066200",
            "telephone_number": "267-571-2469",
            "fax_number": "267-571-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA DIVERSITY CHILDREN'S ORGANIZATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "VARENYCHENKO",
        "authorized_official_first_name": "TETYANA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "267-571-2469",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.