Organization
PEDIATRICS A1, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAGI I ELTEMSAH MD (OWNER)
(201) 222-7899
Entity
Organization
Contact information
Practice address
2775 KENNEDY BLVD, JERSEY CITY, NJ 07306-5515
(201) 222-7899
Mailing address
2775 KENNEDY BLVD, JERSEY CITY, NJ 07306-5515
(201) 222-7899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06245800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7082304
—
NJ
Enumeration date
11/24/2010
Last updated
05/26/2011
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