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IVY PEDIATRICS PA NPI 1871660407


NPI Information

NPI: 1871660407
Provider Name: IVY PEDIATRICS, PA
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 31D1030806

Address:
220 BRIDGE PLAZA DR
MANALAPAN, NJ
ZIP 07726
Phone: (732) 972-9525
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IVY PEDIATRICS, PA is a pediatrics in Manalapan, 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. IVY PEDIATRICS, PA NPI is 1871660407. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

220 BRIDGE PLAZA DR
MANALAPAN, NJ
ZIP 07726-729
Phone: (732) 972-9525
Fax: (732) 972-9055

The provider's authorized official is Igor Trogan .
The authorized official title is President and has the following contact phone number (732) 972-9525.

The CLIA number assigned to this NPI record is 31D1030806 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 9/23/2010.


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
1208000000XPediatrics25MA075803NEW 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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