# HACKETTSTOWN PEDIATRICS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316211915
- **Authorized official:** TERRI CARPENTER (OFFICE MANAGER)
- **Authorized official phone:** (908) 852-8096

## Contact information

- **Practice address:** 4 DOCTORS PARK, SUITE C, HACKETTSTOWN, NJ 07840-1716
- **Practice address phone:** (908) 852-8096
- **Practice address fax:** (908) 852-5012
- **Mailing address:** 4 DOCTORS PARK, SUITE C, HACKETTSTOWN, NJ 07840-1716
- **Mailing address phone:** (908) 852-8096
- **Mailing address fax:** (908) 852-5012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 25MA07788100 | NJ | Yes |

## Other

- **Enumeration date:** 02/28/2012
- **Last updated:** 01/04/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0060691 | — | NJ |
| 01 | — | 1326045295 | TYPE 1 NPI | NJ |