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CENTER FOR PEDIATRICS ADOLESCENT AND ADULT MEDICINE OF SNJ PA NPI 1467508796


NPI Information

NPI: 1467508796
Provider Name: CENTER FOR PEDIATRICS ADOLESCENT AND ADULT MEDICINE OF SNJ PA
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 31D0996699

Address:
12000 LINCOLN DR W
SUITE 311
MARLTON, NJ
ZIP 08053
Phone: (856) 985-8100
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CENTER FOR PEDIATRICS ADOLESCENT AND ADULT MEDICINE OF SNJ PA is a pediatrics in Marlton, 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. CENTER FOR PEDIATRICS ADOLESCENT AND ADULT MEDICINE OF SNJ PA NPI is 1467508796. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12000 LINCOLN DR W
SUITE 311
MARLTON, NJ
ZIP 08053-402
Phone: (856) 985-8100
Fax: (856) 985-8374

The provider's authorized official is Jay Mirmanesh .
The authorized official title is President and has the following contact phone number (856) 985-8100.

The CLIA number assigned to this NPI record is 31D0996699 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/27/2007 and was last updated on 8/22/2020.


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
1208000000XPediatrics25MA05186900NEW 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: 4/28/2024

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