Organization
SOUTH JERSEY PEDIATRIC ENDOCRINOLOGY, LLC
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTINE O CHIKEZIE MD (MEDICAL DIRECTOR)
(609) 204-0698
Entity
Organization
Contact information
Practice address
6712 WASHINGTON AVE, SUITE 203, EGG HARBOR TWP, NJ 08234-1999
(609) 204-0698
(609) 272-3099
Mailing address
6712 WASHINGTON AVE, SUITE 203, EGG HARBOR TWP, NJ 08234-1999
(609) 204-0698
(609) 272-3099
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
25MA05978100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7848803
—
NJ
Enumeration date
01/08/2009
Last updated
01/08/2009
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