Candlewood Pediatrics

NPI 1134545429 - Pediatrics - 208000000X

NPI Details
NPI 1134545429
Enumeration Date 03/11/2014
Last Updated 04/04/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name TATYANA TATYANA
Position PROPRIETOR/MEDICAL DOCTOR
Phone (732) 280-3100
Fax (732) 280-3103
Practice Location
1540 HWY. 138
SUITE 105
WALL NJ, 07719, US
Phone (732) 280-3100
Fax (732) 280-3103
Business Location
1540 HWY. 138
SUITE 105
WALL NJ, 07719, US
Phone (732) 280-3100
Fax (732) 280-3103
Toxanomy
Taxonomy Code 208000000X
License State New Jersey
License Number 25MA06638500
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According to our database, Candlewood Pediatrics NPI is 1134545429, taxonomy code is 208000000X and license number is 25MA06638500, license state is located at New Jersey. Candlewood Pediatrics physically located at 1540 Hwy. 138, Wall NJ, 07719. NPI Number 1033115704 has the healthcare provider type.

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1134545429 NPI number is provided on an as is basis without warranty of any kind. 1134545429 is maintained by the National Plan & Provider Enumeration System. The contents of Candlewood Pediatrics are for informational purposes only.