PROVIDENCE PEDIATRIC MEDICAL DAYCARE INC NPI 1568621852

NPI Information

PROVIDENCE PEDIATRIC MEDICAL DAYCARE INC is a medically fragile infants and children day care clinic center in Camden, NJ. The provider is an entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). PROVIDENCE PEDIATRIC MEDICAL DAYCARE INC NPI is 1568621852. The provider is registered as an organization entity type.

The provider's business location address is:

1000 ATLANTIC AVE
CAMDEN E, 1ST FLOOR
CAMDEN, NJ
ZIP 08104-132
Phone: (856) 338-1350
Fax: (856) 338-1406

The provider's authorized official is Leeanna Roman .
The authorized official title is President and has the following contact phone number (856) 753-7763.

The enumeration date for this NPI number is 6/3/2008 and was last updated on 6/3/2008.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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