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General NPI Number Information
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NPI Number | 1134448178
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Entity Type | Organization
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Legal Business Name | WOODLAND PARK PEDIATRICS PC
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 205 BROWERTOWN RD SUITE 001
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-2671
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Country | US
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Telephone | 973-582-0644
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Fax | 973-580-0605
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Provider Business Mailing Address
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Address Line | 205 BROWERTOWN RD SUITE 001
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-2671
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Country | US
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Telephone | 973-582-0644
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Fax | 973-580-0605
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MANNAN RAZZAK
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Credential | MD
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Telephone | 973-582-0644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NJ
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