Healthcare Provider Details

I. General information

NPI: 1073741856
Provider Name (Legal Business Name): CLIFTON PEDIATRICS, PTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

296 CLIFTON AVE
CLIFTON NJ
07011-2223
US

IV. Provider business mailing address

296 CLIFTON AVE
CLIFTON NJ
07011-2223
US

V. Phone/Fax

Practice location:
  • Phone: 973-249-8211
  • Fax: 973-249-8611
Mailing address:
  • Phone: 973-249-8211
  • Fax: 973-249-8611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number25MA06623700
License Number StateNJ

VIII. Authorized Official

Name: DR. MELIH SARIGUL
Title or Position: PHYSICIAN/PARTNER
Credential: M.D.
Phone: 973-249-8211