Healthcare Provider Details

I. General information

NPI: 1649335290
Provider Name (Legal Business Name): ABC PEDIATRIC ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 DRUM POINT RD
BRICK NJ
08723-6221
US

IV. Provider business mailing address

131 DRUM POINT RD
BRICK NJ
08723-6221
US

V. Phone/Fax

Practice location:
  • Phone: 732-477-8988
  • Fax: 732-477-8780
Mailing address:
  • Phone: 732-477-8988
  • Fax: 732-477-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA PIELA
Title or Position: PHYSICIAN
Credential: MD
Phone: 732-477-8988