Organization
ACADEMY PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YULIYA BAKSHIYEV MD (PRESIDENT)
(732) 617-8888
Entity
Organization
Contact information
Practice address
25 KILMER DR, MORGANVILLE, NJ 07751-1564
(732) 617-8888
(732) 617-8880
Mailing address
25 KILMER DR, MORGANVILLE, NJ 07751-1564
(732) 617-8888
(732) 617-8880
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA64214
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6969202
—
NJ
Enumeration date
10/02/2007
Last updated
10/02/2007
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