Healthcare Provider Details

I. General information

NPI: 1225088917
Provider Name (Legal Business Name): QUALITY CARE PEDIATRICS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 ZION RD SUITE 204
NORTHFIELD NJ
08225-1844
US

IV. Provider business mailing address

PO BOX 8505
CHERRY HILL NJ
08002-0505
US

V. Phone/Fax

Practice location:
  • Phone: 609-641-7008
  • Fax: 609-641-7028
Mailing address:
  • Phone: 856-755-1616
  • Fax: 856-755-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARIA C MOLINA
Title or Position: OWNER
Credential: M.D.
Phone: 609-641-7008