Healthcare Provider Details

I. General information

NPI: 1780549113
Provider Name (Legal Business Name): GARDENTOTS PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 FRANKLIN AVE STE 204
NUTLEY NJ
07110-2900
US

IV. Provider business mailing address

4 TANGER DR
LIVINGSTON NJ
07039-1429
US

V. Phone/Fax

Practice location:
  • Phone: 862-228-3127
  • Fax:
Mailing address:
  • Phone: 862-228-3127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. RINET FERNANDES
Title or Position: PHYSICIAN
Credential: MD
Phone: 862-228-3127