Organization
PEDIATRIC HEALTH, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOPEZ ROBERTA (COMPTROLLER)
(732) 409-3633
Entity
Organization
Contact information
Practice address
69 W MAIN ST, FREEHOLD, NJ 07728-2114
(732) 409-3633
(732) 409-7133
Mailing address
69 W MAIN ST, FREEHOLD, NJ 07728-2114
(732) 409-3633
(732) 409-7133
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3196305
—
NJ
Enumeration date
08/30/2006
Last updated
07/20/2010
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