Organization
BRIGHT FUTURE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK VAN MARTIN-YEBOAH (OWNER)
(973) 414-1886
Entity
Organization
Contact information
Practice address
86 S HARRISON ST, EAST ORANGE, NJ 07018-1704
(973) 414-1886
Mailing address
PO BOX 3155, EAST ORANGE, NJ 07019-3155
(973) 414-1886
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA061936
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6529402
—
NJ
Enumeration date
05/23/2006
Last updated
01/23/2008
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