Healthcare Provider Details

I. General information

NPI: 1306904503
Provider Name (Legal Business Name): CHILDRENS EMERGENCY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ CHILDRENS EMERGENCY SERVICE INC
DAYTON OH
45404
US

IV. Provider business mailing address

307 S. EVERGREEN AVENUE CHILDRENS EMERGENCY SERVICES INC
WOODBURY NJ
08096-2936
US

V. Phone/Fax

Practice location:
  • Phone: 856-686-4316
  • Fax: 865-291-3254
Mailing address:
  • Phone: 856-686-4316
  • Fax: 865-291-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number525169
License Number StateOH

VIII. Authorized Official

Name: DAVID ISTVAN
Title or Position: OWNER
Credential: MD
Phone: 856-686-4316