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CANDLEWOOD PEDIATRICS NPI 1134545429


NPI Information

NPI: 1134545429
Provider Name: CANDLEWOOD PEDIATRICS

Doing Business As: TATYANA SHKOLNAYA

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 31D2132660

Address:
1540 HWY. 138
SUITE 105
WALL, NJ
ZIP 07719
Phone: (732) 280-3100
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CANDLEWOOD PEDIATRICS is a pediatrics in Wall, NJ. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. CANDLEWOOD PEDIATRICS NPI is 1134545429. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Tatyana Shkolnaya.

The provider's business location address is:

1540 HWY. 138
SUITE 105
WALL, NJ
ZIP 07719
Phone: (732) 280-3100
Fax: (732) 280-3103

The provider's authorized official is Tatyana Shkolnaya .
The authorized official title is Proprietor/medical Doctor and has the following contact phone number (732) 280-3100.

The CLIA number assigned to this NPI record is 31D2132660 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/11/2014 and was last updated on 4/4/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics25MA06638500NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11497729842OTHERNEW JERSEYNPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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