Organization
CANDLEWOOD PEDIATRICS
Active
Other names
TATYANA SHKOLNAYA
Organization subpart
No
Provider details
NPI number
Authorized official
TATYANA SHKOLNAYA M.D. (PROPRIETOR/MEDICAL DOCTOR)
(732) 280-3100
Entity
Organization
Contact information
Practice address
1540 HWY. 138, SUITE 105, WALL, NJ 07719
(732) 280-3100
(732) 280-3103
Mailing address
1540 HWY. 138, SUITE 105, WALL, NJ 07719
(732) 280-3100
(732) 280-3103
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06638500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497729842
NPI
NJ
Enumeration date
03/11/2014
Last updated
04/04/2014
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