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OrganizationMedicare enrolled

Lakeside Medical Group PLLC

Doing business as Heritage Care

Pediatrics · Philadelphia, PA

Source: NPPES NPI RegistryFetched 2026-10-20

Public record

NPI
1000000363
Enumeration date
2026-09-08
Last updated
2026-09-22
Practice location
1436 Lamar Blvd
Philadelphia, PA 19103
Taxonomies
Medicare
Enrolled