Organization
PEDI DOC, P.A.
Active
Parent organization
ESSEX PEDI DOC, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSEX PEDI DOC, LLC
Authorized official
BERNIER LAUREDAN MD (MEDICAL DIRECTOR)
(973) 371-1600
Entity
Organization
Contact information
Practice address
205 SMITH ST, SUITE D, PERTH AMBOY, NJ 08861-4323
(732) 697-1600
Mailing address
22 BALL ST, SUITE 100, IRVINGTON, NJ 07111-3521
(973) 371-1600
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
25MA05388700
NJ
Other
Enumeration date
07/13/2006
Last updated
03/22/2013
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