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General NPI Number Information
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NPI Number | 1013949189
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Entity Type | Organization
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Legal Business Name | TENDERCARE PEDIATRICS
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 2322 NEW RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1440
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Country | US
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Telephone | 609-641-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 2322 NEW RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1440
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Country | US
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Telephone | 609-641-0200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PADMA MANDALAPU
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Credential | M.D., F.A.A.P
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Telephone | 609-641-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MA65706
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License Number State | NJ
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