Organization
PEDIATRIC FAMILY HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICJA T UCZKOWSKA M.D. (REPRESENTATIVE)
(973) 726-0565
Entity
Organization
Contact information
Practice address
10 MORAN ST, NEWTON, NJ 07860-1806
(973) 940-0407
(973) 579-0016
Mailing address
399 WEST MOUNTAIN RD., SPARTA, NJ 07871-1003
(973) 726-0565
(974) 579-0016
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA07239500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0480690
—
NJ
01
—
145746279
HACKENSACK UNIVERSITY MEDICAL CENTAR
NJ
Enumeration date
10/08/2014
Last updated
02/05/2016
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