PEDIATRICS & ADOLESCENT SAINT MARY CLINIC LLC NPI 1831555705

NPI Information

NPI: 1831555705
Provider Name: PEDIATRICS & ADOLESCENT SAINT MARY CLINIC, LLC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
65 KEARNY AVE
KEARNY, NJ
ZIP 07032
Phone: (646) 388-2111
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PEDIATRICS & ADOLESCENT SAINT MARY CLINIC, LLC is an adolescent medicine pediatrics in Kearny, 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. PEDIATRICS & ADOLESCENT SAINT MARY CLINIC, LLC NPI is 1831555705. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

65 KEARNY AVE
KEARNY, NJ
ZIP 07032-334
Phone: (646) 388-2111

The provider's authorized official is Inas Wassef .
The authorized official title is Owner and has the following contact phone number (646) 388-2111.

The enumeration date for this NPI number is 1/8/2016 and was last updated on 1/8/2016.

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
1	2080A0000X	Pediatrics	Adolescent Medicine	25MA09372400	NEW JERSEY	Yes

What is NPI?

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

NPI Synchronization or Removal

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