Healthcare Provider Details

I. General information

NPI: 1679995393
Provider Name (Legal Business Name): TOP NOTCH PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 04/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 MAIN ST
HACKENSACK NJ
07601-4914
US

IV. Provider business mailing address

899 MAIN ST
HACKENSACK NJ
07601-4914
US

V. Phone/Fax

Practice location:
  • Phone: 201-820-4600
  • Fax: 201-820-4597
Mailing address:
  • Phone: 201-820-4600
  • Fax: 201-820-4597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MB07995400
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ALISSA H ZENACK
Title or Position: MANAGING MEMBER
Credential: D.O.
Phone: 201-820-4600