Organization
ELIZABETH PEDIATRIC GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH JAMES DAVIS MD (OWNER)
(908) 354-9500
Entity
Organization
Contact information
Practice address
701 NEWARK AVE, SUITE 212, ELIZABETH, NJ 07208-3550
(908) 354-9500
(908) 354-9077
Mailing address
701 NEWARK AVE, SUITE 212, ELIZABETH, NJ 07208-3550
(908) 354-9500
(908) 354-9077
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA04177300
NJ
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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