Organization
ESSEX PEDI DOCS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNIER LAUREDAN M.D. (OWNER)
(973) 371-1600
Entity
Organization
Contact information
Practice address
22 BALL ST, IRVINGTON, NJ 07111-3521
(973) 371-1600
(973) 372-7677
Mailing address
22 BALL ST, IRVINGTON, NJ 07111-3521
(973) 371-1600
(973) 372-7677
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA53887
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0677701
—
NJ
Enumeration date
04/27/2011
Last updated
04/27/2011
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