Organization
UNIVERSAL PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NKEM VESTA NNAETO M.D. (OWNER)
(973) 674-0036
Entity
Organization
Contact information
Practice address
169-177 CENTRAL AVE, ORANGE, NJ 07050-3430
(973) 674-0036
(973) 674-0322
Mailing address
169-177 CENTRAL AVE, ORANGE, NJ 07050-3430
(973) 674-0036
(973) 674-0322
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7065906
—
NJ
Enumeration date
10/11/2006
Last updated
01/28/2022
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