PEDIATRIA HEALTHCARE FOR KIKS - NPI 1619104734 - Physical Therapist in Wilkes Barre, PA

Q: What is the provider's specialty?

The provider's specialty is Physical Therapist with taxonomy code 2251P0200X and a focus in Pediatrics.

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About Pediatria Healthcare For Kiks NPPES

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

PEDIATRIA HEALTHCARE FOR KIKS (NPI 1619104734) is a healthcare organization registered as a pediatrics in Wilkes Barre, Pennsylvania and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through May 11, 2027 and lists Susan E. Dignan, General Counsel, as its authorized official.

NPPES Registry Identity

NPI1619104734

Entity TypeOrganization

Primary Taxonomy2251P0200X

Legal Business NamePEDIATRIA HEALTHCARE, LLC

Location Address53 GRAVEL ST, SUITE CWilkes Barre, PA 18705-3738

Mailing Address53 Gravel St, Suite CWilkes Barre, PA 18705-3738 · (570) 371-5600 · Fax (570) 371-5606

Phone(570) 371-5600

Fax(570) 371-5606

Organization SubpartNo

Authorized OfficialSusan E. DignanGeneral Counsel · (770) 840-1966

Enumeration DateJune 16, 2009

Last NPPES UpdateFebruary 4, 2016

✔ NPI 1619104734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPhysical Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251P0200X

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.

Also ListedOccupational Therapist · PediatricsTaxonomy 225XP0200X

Also ListedRespiratory Therapist, Certified · Neonatal/PediatricsTaxonomy 2278P3900X

Also ListedSpeech-Language PathologistTaxonomy 235Z00000X

53 GRAVEL ST, Wilkes Barre, PA 18705

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Other Names 1

Doing Business AsPediatria Healthcare For Kiks

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2095766

Pediatria Hc LLC Dba Aveanna Hc · Wilkes Barre, PA

Active · expires May 11, 2027

CLIA Number39D2095766

Laboratory TypePecc

Certificate Effective DateMay 12, 2025

Certificate Expiration DateMay 11, 2027

Laboratory DirectorDr. Azra M. Sehic

Laboratory Phone(570) 371-5600

Laboratory LocationPediatria Hc LLC Dba Aveanna Hc53 Gravel Street, Suite C, Wilkes Barre, PA 18705

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

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

TERESSA ANN POLINSKY PHARM.D.

Pharmacist