Organization
MONMOUTH PEDIATRIC GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM WASSEL MD (PARTNER)
(732) 741-0456
Entity
Organization
Contact information
Practice address
272 BROAD ST, RED BANK, NJ 07701-2003
(732) 741-0456
(732) 219-9477
Mailing address
272 BROAD ST, RED BANK, NJ 07701-2003
(732) 741-0456
(732) 219-9477
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2661004
—
NJ
Enumeration date
06/10/2006
Last updated
08/22/2020
Update your record
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