Organization
SOMERSET PEDIATRIC GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY PARLAVECCHIO RN (CHIEF ADMINISTRATIVE OFFICER)
(908) 725-5530
Entity
Organization
Contact information
Practice address
575 ROUTE 28 STE 2100, RARITAN, NJ 08869-1363
(908) 725-1802
(908) 203-8825
Mailing address
575 ROUTE 28 STE 2205, RARITAN, NJ 08869-1363
(908) 725-5530
(908) 253-6559
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080S0010X
Pediatric Sports Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2622807
—
NJ
Enumeration date
10/27/2006
Last updated
06/04/2021
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