MYSTIC ISLAND PEDIATRIC ASSOCIATES LLC NPI 1679892533

NPI Information

MYSTIC ISLAND PEDIATRIC ASSOCIATES, LLC is a medical specialty clinic center in Little Egg Harbor Twp, NJ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). MYSTIC ISLAND PEDIATRIC ASSOCIATES, LLC NPI is 1679892533. The provider is registered as an organization entity type.

The provider's business location address is:

104 E ANCHOR DR
LITTLE EGG HARBOR TWP, NJ
ZIP 08087-643
Phone: (609) 294-5500
Fax: (609) 294-5700

The provider's authorized official is Gene Chiu Lee .
The authorized official title is Vp and has the following contact phone number (609) 294-5500.

The enumeration date for this NPI number is 5/18/2010 and was last updated on 5/18/2010.

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:

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