Organization
CENTER FOR PEDIATRICS ADOLESCENT AND ADULT MEDICINE OF SNJ PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY MIRMANESH MD (PRESIDENT)
(856) 985-8100
Entity
Organization
Contact information
Practice address
12000 LINCOLN DR W, SUITE 311, MARLTON, NJ 08053-3402
(856) 985-8100
(856) 985-8374
Mailing address
12000 LINCOLN DR W STE 311, MARLTON, NJ 08053-3405
(856) 985-8100
(856) 985-8374
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA05186900
NJ
Other
Enumeration date
01/27/2007
Last updated
08/22/2020
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