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NPI Code Detail

MEDICARE: QUALITY CARE PEDIATRICS, LLC.

MEDICARE: QUALITY CARE PEDIATRICS, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12150788001OTHERNJAMERIHEALTH HMO/PPO
2149849OTHERAETNA HMO

General Provider Information

NPI Number : 1225088917
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUALITY CARE PEDIATRICS, LLC.
Provider Business Mailing Address
First Line : PO BOX 8505
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08002-0505
Country : US
Telephone Number : 856-755-1616
Fax Number : 856-755-0098
Provider Business Practice Location Address
First Line : 1750 ZION RD
Second Line : SUITE 204
City : NORTHFIELD
State : NJ
Zip : 08225-1844
Country : US
Telephone Number : 609-641-7008
Fax Number : 609-641-7028
Authorized Official
Title or Position : OWNER
Name : MARIA C MOLINA
Credential : M.D.
Telephone Number : 609-641-7008
Provider Enumeration Date : 05/11/2006
Last Update Date : 08/22/2020

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Directions to “QUALITY CARE PEDIATRICS, LLC. ” Practice Location

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