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Organization

PEDIATRIC INTENSIVE CARE ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN M. TEDESCHI MD (CEO/ CHAIRMAN)
(856) 782-3300
Entity
Organization

Contact information

Practice address
101 CARNIE BLVD, PICU, VOORHEES, NJ 08043-1548
(856) 782-3300
(856) 504-8029
Mailing address
402 LIPPINCOTT DR, MARLTON, NJ 08053-4112
(856) 782-3300
(856) 504-8029

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041581
NJ
Enumeration date
05/20/2006
Last updated
03/04/2010
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