Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Pediatric Practice LLC

Organization Pediatrics Physician · NPI 1932160629

Providence Pediatric Practice LLC is a Pediatrics Physician in Media, Pennsylvania. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 Granite Dr Ste 200
Media, PA 19063-5134
Phone: (610) 565-1945
Fax: (610) 892-7848
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1932160629
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacquelyn Gibbons — Physician Senior Partner · (610) 565-1945
NPI enumeratedMarch 31, 2006
Last updated in NPPESMarch 18, 2009
Mailing address100 Granite Dr, Suite 200, Media, PA 19063-5134

Other providers in Media