Provider Type Icon

BERGEN PEDIATRIC CENTERP.C NPI 1750302683


NPI Information

NPI: 1750302683
Provider Name: BERGEN PEDIATRIC CENTER,P.C
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 31D0974669

Address:
167 S WASHINGTON AVE
BERGENFIELD, NJ
ZIP 07621
Phone: (201) 384-8510
Get Directions

BERGEN PEDIATRIC CENTER,P.C is a pediatrics in Bergenfield, 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. BERGEN PEDIATRIC CENTER,P.C NPI is 1750302683. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

167 S WASHINGTON AVE
BERGENFIELD, NJ
ZIP 07621-903
Phone: (201) 384-8510

The provider's authorized official is Omana Reji Mathew .
The authorized official title is President and has the following contact phone number (201) 384-8510.

The CLIA number assigned to this NPI record is 31D0974669 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/23/2006 and was last updated on 10/28/2008.


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
1208000000XPediatricsMA061019NEW 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.