Providence Pediatric Medical Daycare, Inc.

NPI 1083765010 - Clinic/Center - 261QM3000X

NPI Details
NPI 1083765010
Enumeration Date 01/16/2007
Last Updated 06/03/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LEEANNA LEEANNA
Position PRESIDENT
Phone (856) 338-0900
Fax (856) 338-0029
Practice Location
1000 ATLANTIC AVE
CAMDEN D, 2ND FLOOR
CAMDEN NJ, 08104-1132, US
Phone (856) 338-0900
Fax (856) 338-0029
Business Location
411 COMMERCE LN
WEST BERLIN NJ, 08091-9254, US
Phone (856) 753-7763
Fax (856) 753-7714
Toxanomy
Taxonomy Code 261QM3000X
License State New Jersey
License Number 158222
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According to our database, Providence Pediatric Medical Daycare, Inc. NPI is 1083765010, taxonomy code is 261QM3000X and license number is 158222, license state is located at New Jersey. Providence Pediatric Medical Daycare, Inc. physically located at 1000 Atlantic Ave, Camden NJ, 08104-1132. NPI Number 1033115704 has the healthcare provider type.

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1083765010 NPI number is provided on an as is basis without warranty of any kind. 1083765010 is maintained by the National Plan & Provider Enumeration System. The contents of Providence Pediatric Medical Daycare, Inc. are for informational purposes only.