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Organization

PEDIATRIC SURGERY GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. COLIN BETHEL M.D. (MANAGING MEMBER)
(973) 660-9334
Entity
Organization

Contact information

Practice address
2130 MILLBURN AVE, MAPLEWOOD, NJ 07040-3725
(973) 313-3115
(973) 313-3188
Mailing address
25B VREELAND RD, SUITE 110, FLORHAM PARK, NJ 07932-1900
(973) 660-9334
(973) 660-9732

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary

Other

Enumeration date
08/02/2006
Last updated
12/21/2010
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