Organization
PEDIATRIC NEPHROLOGY AT SAINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK AHEARN (DIRECTOR)
(732) 557-7119
Entity
Organization
Contact information
Practice address
94 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5672
(973) 322-5264
(973) 322-2315
Mailing address
PO BOX 18239, NEWARK, NJ 07191-8239
(732) 557-7160
(732) 557-7109
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7383207
—
NJ
Enumeration date
05/04/2006
Last updated
06/23/2010
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