Organization
ADVANCED PEDIATRICS GROUP, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE DOS SANTOS M.D. (CO OWNER)
(201) 407-9421
Entity
Organization
Contact information
Practice address
5 SUMMIT AVE, SUITE 203, HACKENSACK, NJ 07601-8503
(201) 407-9421
Mailing address
17 RIVER RD APT D, NUTLEY, NJ 07110-3465
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA07427800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093740458
NPI
NJ
Enumeration date
08/12/2009
Last updated
08/12/2009
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