LICKING MEMORIAL PEDIATRICS
NPI 1083634414
Pediatrics in Newark, OH

Q: What is Licking Memorial Professional Corp's NPI number?

The NPI number for Licking Memorial Professional Corp is 1083634414. It was assigned to this organization in the NPPES registry on July 20, 2006. The provider is doing business as Licking Memorial Pediatrics.

Q: What is Licking Memorial Professional Corp's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since July 20, 2006

1865 TAMARACK RD, NEWARK, OH 43055(740) 348-4940(740) 348-4948 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Licking Memorial Pediatrics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LICKING MEMORIAL PEDIATRICS (NPI 1083634414) is a healthcare organization registered as a pediatrics in Newark, Ohio and active in the NPI registry since July 2006. The organization lists Robert A. Montagnese, Executive V.p., as its authorized official.

NPPES Registry Identity

NPI1083634414

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameLICKING MEMORIAL PROFESSIONAL CORP

Location Address1865 TAMARACK RDNewark, OH 43055-2305

Mailing Address1865 Tamarack RdNewark, OH 43055-2305 · (740) 348-4940 · Fax (740) 348-4948

Phone(740) 348-4940

Fax(740) 348-4948

Organization SubpartNo

Authorized OfficialRobert A. MontagneseExecutive V.p. · (740) 348-4000

Enumeration DateJuly 20, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1083634414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1865 TAMARACK RD, Newark, OH 43055

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Other Names 1

Doing Business AsLicking Memorial Pediatrics

Other Identifiers 1

Medicaid0617194OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER HARTMAN RDN

Dietitian, Registered