Provider Type Icon

OLD BERGEN PEDIATRICS PA NPI 1053541599


NPI Information

NPI: 1053541599
Provider Name: OLD BERGEN PEDIATRICS PA
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 31D2158609

Address:
4 HIGHLAND AVE
JERSEY CITY, NJ
ZIP 07306
Phone: (201) 434-3997
Get Directions

OLD BERGEN PEDIATRICS PA is a pediatrics in Jersey City, NJ. The provider is 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. OLD BERGEN PEDIATRICS PA NPI is 1053541599. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 HIGHLAND AVE
JERSEY CITY, NJ
ZIP 07306-510
Phone: (201) 434-3997
Fax: (201) 434-3304

The provider's authorized official is Eduardo Mangosing .
The authorized official title is President and has the following contact phone number (201) 434-3997.

The CLIA number assigned to this NPI record is 31D2158609 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/17/2009 and was last updated on 7/17/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics25MA06888600NEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.