Organization
AMERICAN PEDIATRIC GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAGARATHNA PRABHURAM MD (OWNER)
(732) 940-4134
Entity
Organization
Contact information
Practice address
2864 RTE 27 STE A, NORTH BRUNSWICK, NJ 08902-5010
(732) 940-4134
Mailing address
2864 RTE 27 STE A, NORTH BRUNSWICK, NJ 08902-5010
(732) 940-4134
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA08471400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0387606
—
NJ
Enumeration date
03/10/2014
Last updated
03/10/2014
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