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PEDIATRIC HEALTHCARE
NPI 1679795025
Pediatrics in Salamanca, NY

Active since May 03, 2007CLIA 33D0955034 · Waiver
4039 RTE 219 SUITE 103, SALAMANCA, NY 14779(716) 945-0368(716) 945-0757 Get Directions Write a Review

NPPES record last updated: July 24, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pediatric Healthcare NPPES

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

PEDIATRIC HEALTHCARE (NPI 1679795025) is a healthcare organization registered as a pediatrics in Salamanca, New York and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through October 2, 2027 and lists Srinivas P Thandla, Sole Proprietor, as its authorized official.

NPPES Registry Identity

NPI1679795025
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIATRIC HEALTHCARE
Location Address4039 RTE 219 SUITE 103Salamanca, NY 14779-9625
Mailing Address4039 Rte 219 Suite 103Salamanca, NY 14779-9625 · (716) 945-0368 · Fax (716) 945-0757
Phone(716) 945-0368
Fax(716) 945-0757
Organization SubpartNo
Authorized OfficialSrinivas P ThandlaSole Proprietor · (716) 945-0368
Enumeration DateMay 3, 2007
Last NPPES UpdateJuly 24, 2008
✔ NPI 1679795025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 237701
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.

4039 RTE 219 SUITE 103, Salamanca, NY 14779
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Other Identifiers 1

Medicaid02056637NY

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

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 33D0955034

Pediatric Healthcare · Salamanca, NY
Active · expires Oct 2, 2027
CLIA Number33D0955034
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateOctober 3, 2025
Certificate Expiration DateOctober 2, 2027
Laboratory DirectorSrinivas P. Thandla MD
Laboratory Phone(716) 945-0368
Laboratory LocationPediatric Healthcare4039 Rte 219 - Suite 103, Salamanca, NY 14779
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Healthcare's NPI number?

The NPI number for Pediatric Healthcare is 1679795025. It was assigned to this organization in the NPPES registry on May 3, 2007.

Where is Pediatric Healthcare located?

Pediatric Healthcare is located at 4039 Rte 219 Suite 103, Salamanca, NY 14779. The listed phone number is (716) 945-0368.

What is Pediatric Healthcare's specialty?

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

Does Pediatric Healthcare hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0955034) is associated with this NPI, valid through October 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric Healthcare was last updated on July 24, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.