Healthcare Provider Details

I. General information

NPI: 1821105404
Provider Name (Legal Business Name): KUSER PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 KUSER ROAD SUITE C1
HAMILTON NJ
08619
US

IV. Provider business mailing address

1544 KUSER ROAD SUITE C1
HAMILTON NJ
08619
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-2200
  • Fax: 609-585-2206
Mailing address:
  • Phone: 609-585-2200
  • Fax: 609-585-2206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

# 1
Identifier01000219401
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERICHOICE
# 2
Identifier2K2758
Identifier TypeOTHER
Identifier State
Identifier IssuerHEALTHNET
# 3
Identifier2697588
Identifier TypeOTHER
Identifier State
Identifier IssuerGHI
# 4
Identifier5060907
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer
# 5
Identifier2144125001
Identifier TypeOTHER
Identifier State
Identifier IssuerKEYSTONE
# 6
Identifier2144125001
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERIHEALTH
# 7
Identifier1047088
Identifier TypeOTHER
Identifier State
Identifier IssuerHORIZON NJ HEALTH
# 8
Identifier30010052
Identifier TypeOTHER
Identifier State
Identifier IssuerKEYSTONE MERCY

VIII. Authorized Official

Name: AMARISH SHETH
Title or Position: PHYSICIAN
Credential: MD
Phone: 609-585-2200