Healthcare Provider Details
I. General information
NPI: 1700809092
Provider Name (Legal Business Name): ATLANTIC EMERGENCY PHYSICIAN TEAM PEDIATRIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE NJ
08012-2453
US
IV. Provider business mailing address
PO BOX 634823
CINCINNATI OH
45263-4823
US
V. Phone/Fax
- Phone: 856-582-2500
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBIN
TRACCI
MOUGANIS
Title or Position: DIRECTOR
Credential:
Phone: 856-686-4394