KOALA PEDIATRICS NPI 1740842962

NPI Information

  • NPI: 1740842962
  • Provider Name: KOALA PEDIATRICS
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 31D2168834
  • Address: 121 CENTER GROVE RD STE 15
    RANDOLPH, NJ
    ZIP 07869
  • Phone: (973) 361-4900

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NPI Details

KOALA PEDIATRICS is a pediatrics in Randolph, 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. KOALA PEDIATRICS NPI is 1740842962. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

121 CENTER GROVE RD STE 15
RANDOLPH, NJ
ZIP 07869-453
Phone: (973) 361-4900
Fax: (973) 361-1842

The provider's authorized official is Fiona Pakonis .
The authorized official title is Physician and has the following contact phone number (973) 361-4900.

The CLIA number assigned to this NPI record is 31D2168834 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/9/2019 and was last updated on 7/9/2019.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsYes

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: 11/21/2025

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