Organization
BERGEN PEDIATRIC CENTER,P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMANA REJI MATHEW (PRESIDENT)
(201) 384-8510
Entity
Organization
Contact information
Practice address
167 S WASHINGTON AVE, BERGENFIELD, NJ 07621-2903
(201) 384-8510
Mailing address
167 S WASHINGTON AVE, BERGENFIELD, NJ 07621-2903
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA061019
NJ
Other
Enumeration date
07/23/2006
Last updated
10/28/2008
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