Organization
VINELAND PEDIATRICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH L MCMASTER RN (OFFICE MANAGER)
(856) 692-1108
Entity
Organization
Contact information
Practice address
1138 E CHESTNUT AVE #5B, VINELAND, NJ 08360-5062
(856) 692-1108
(856) 692-2077
Mailing address
1138 E CHESTNUT AVE #5B, VINELAND, NJ 08360-5062
(856) 692-1108
(856) 692-2077
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0513129001
AMERIHEALTH HIPPA
—
01
—
1043187
HORIZON HEALTH
NJ
01
—
3041
AETNA
—
05
—
3394603
—
NJ
01
—
679080
AMERIHEALTH
—
01
—
E337
AMERIGROUP
—
01
—
F03778
PHYSICIANS HEALTH
—
Enumeration date
08/31/2006
Last updated
07/16/2010
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