Provider Demographics
NPI:1609602937
Name:INSIGHTFUL PEDIATRICS
Entity type:Organization
Organization Name:INSIGHTFUL PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO- OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-903-8958
Mailing Address - Street 1:11519 WILLOW BEND DR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-7717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:755 W CARMEL DR STE 203
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5875
Practice Address - Country:US
Practice Address - Phone:847-903-8958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service