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Organization

RIVENDELL PEDIATRIC AND ADOLSCENT MEDICINE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH MICHAEL HIRSCH MD (MD/PRES)
(609) 424-0340
Entity
Organization

Contact information

Practice address
25 HOMESTEAD DR, STE H, COLUMBUS, NJ 08022-1005
(609) 424-0340
(609) 298-7452
Mailing address
25 HOMESTEAD DR, STE H, COLUMBUS, NJ 08022-1005
(609) 424-0340
(609) 298-7452

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA04122800
NJ

Other

Enumeration date
06/12/2006
Last updated
08/22/2020
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