Healthcare Provider Details

I. General information

NPI: 1538489372
Provider Name (Legal Business Name): SHERIDAN CHILDREN'S HEALTHCARE SERVICES OF NEW JERSEY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 GRAND ST
JERSEY CITY NJ
07302-4321
US

IV. Provider business mailing address

PO BOX 452288
SUNRISE FL
33345-2288
US

V. Phone/Fax

Practice location:
  • Phone: 201-915-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. M. RICHARD AUERBACH
Title or Position: PRESIDENT
Credential: MD
Phone: 954-838-2371