Organization
VENTNOR PEDIATRICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMIOLA ASEMOTA M.D. (OWNER)
(609) 487-6507
Entity
Organization
Contact information
Practice address
6601 VENTNOR AVE, SUITE 14, VENTNOR, NJ 08406-2167
(609) 487-6507
(609) 487-6508
Mailing address
6601 VENTNOR AVE, SUITE 14, VENTNOR, NJ 08406-2167
(609) 487-6509
(609) 487-6508
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0294497
—
NJ
01
—
2255928001
AMERIHEALTH HMO/PPO
NJ
Enumeration date
05/10/2006
Last updated
01/02/2014
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