Healthcare Provider Details

I. General information

NPI: 1033204052
Provider Name (Legal Business Name): CHILDREN'S HEALTH CARE ASSOCIATES OF NEW JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 LAUREL OAK RD SPECIALTY CENTER AT VOORHEES - CHOP
VOORHEES NJ
08043-3505
US

IV. Provider business mailing address

3401 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4319
US

V. Phone/Fax

Practice location:
  • Phone: 856-435-1300
  • Fax: 215-977-8864
Mailing address:
  • Phone: 267-425-9408
  • Fax: 215-977-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YASMEN MOHAMMAD
Title or Position: CFO
Credential:
Phone: 215-409-8288