Organization
BLOOMFIELD PEDIATRICS,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNA RETIRACION LOPEZ-MASLAK M.D. (OWNER)
(973) 743-0202
Entity
Organization
Contact information
Practice address
329 BELLEVILLE AVENUE, 2ND FLOOR, BLOOMFIELD, NJ 07003-5902
(973) 743-0202
(973) 743-0777
Mailing address
329 BELLEVILLE AVENUE, 2ND FLOOR, BLOOMFIELD, NJ 07003-5902
(973) 743-0202
(973) 743-0777
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MA065388
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8148309
—
NJ
Enumeration date
03/22/2007
Last updated
04/02/2012
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