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C AND M KINTIROGLOU MD'S PA NPI 1689969396


NPI Information

NPI: 1689969396
Provider Name: C AND M KINTIROGLOU MD'S PA
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 31D0104674

Address:
1500 PLEASANT VALLEY WAY
SUITE 301
WEST ORANGE, NJ
ZIP 07052
Phone: (973) 243-0002
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C AND M KINTIROGLOU MD'S PA is an adolescent medicine pediatrics in West Orange, NJ. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. C AND M KINTIROGLOU MD'S PA NPI is 1689969396. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1500 PLEASANT VALLEY WAY
SUITE 301
WEST ORANGE, NJ
ZIP 07052-956
Phone: (973) 243-0002

The provider's authorized official is Brigette Fullard .
The authorized official title is Office Manager and has the following contact phone number (973) 243-0002.

The CLIA number assigned to this NPI record is 31D0104674 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/10/2011 and was last updated on 6/10/2011.


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
12080A0000XPediatricsAdolescent Medicine25MA03124000NEW JERSEYYes

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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