Organization
PREVENTATIVE PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRIAM SPEARS DO (OWNER)
(609) 219-5110
Entity
Organization
Contact information
Practice address
450 OCEAN AVE, JERSEY CITY, NJ 07305-3274
(609) 219-5110
Mailing address
450 OCEAN AVE, JERSEY CITY, NJ 07305-3274
(609) 219-5110
(609) 498-7254
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770841322
NPI
NJ
Enumeration date
08/23/2021
Last updated
08/23/2021
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