Organization
PEDS PURPOSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY TUCKER MD (CEO)
(240) 602-6023
Entity
Organization
Contact information
Practice address
525 ROUTE 73 N STE 104, MARLTON, NJ 08053-3422
(856) 230-7208
Mailing address
140 GREAT RD, MAPLE SHADE, NJ 08052-3048
(240) 602-6023
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/05/2019
Last updated
12/16/2019
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