Healthcare Provider Details
I. General information
NPI: 1417901521
Provider Name (Legal Business Name): PNP PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 N HARRISON ST PRINCETON SHOPPING CENTER
PRINCETON NJ
08540-3512
US
IV. Provider business mailing address
196 PRINCETON HIGHTSTOWN RD
WEST WINDSOR NJ
08550-1672
US
V. Phone/Fax
- Phone: 609-921-3441
- Fax: 609-921-3441
- Phone: 609-799-4311
- Fax: 609-799-8117
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ADAM
BRETT
NADDELMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 609-799-4311