Organization
KINDCARE PEDIATRIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOCASTA FERNANDEZ MD (OWNER)
(973) 574-8688
Entity
Organization
Contact information
Practice address
287 MONROE ST, PASSAIC, NJ 07055-5209
(973) 574-8688
Mailing address
PO BOX 667, BELLEVILLE, NJ 07109-0667
(973) 574-8688
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA077362
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0039586
—
NJ
Enumeration date
05/25/2006
Last updated
01/04/2012
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