Healthcare Provider Details

I. General information

NPI: 1588816896
Provider Name (Legal Business Name): HEALTH FIRST PEDIATRICS ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 10/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 CRANBURY RD SUITE D
EAST BRUNSWICK NJ
08816-5405
US

IV. Provider business mailing address

579 CRANBURY RD SUITE D
EAST BRUNSWICK NJ
08816-5405
US

V. Phone/Fax

Practice location:
  • Phone: 732-698-9080
  • Fax:
Mailing address:
  • Phone: 732-698-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA710778
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberMA71078
License Number StateNJ

VIII. Authorized Official

Name: DR. YAN LI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-698-9080