Organization
SUNNYSIDE PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTINA U ANYANWU MD (OWNER)
(973) 399-0571
Entity
Organization
Contact information
Practice address
1182 STUYVESANT AVE, IRVINGTON, NJ 07111-1057
(973) 399-0571
(973) 399-1555
Mailing address
1182 STUYVESANT AVE, IRVINGTON, NJ 07111-1057
(973) 399-0571
(973) 399-1555
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MA06019
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7191308
—
NJ
Enumeration date
02/28/2012
Last updated
02/28/2012
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