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General NPI Number Information
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NPI Number | 1194964593
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HEALTHCARE ASSOCIATES OF NEW JERSEY, PC
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Dates
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Enumeration Date | 02/10/2009
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 1 PLAINSBORO RD CHOP CARE NETWORK AT PRINCETON MEDICAL CENTER
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City | PLAINSBORO
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State | NJ
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Zip | 08536-1913
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Country | US
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Telephone | 609-497-4431
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Fax | 267-425-9299
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Provider Business Mailing Address
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Address Line | 100 E PENN SQ FL 9 CHILDREN'S HEALTHCARE ASSOCIATES OF NEW JERSEY PC
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City | PHILADELPHIA
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State | PA
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Zip | 19107-3323
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Country | US
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Telephone | 267-425-9233
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Fax | 267-425-9299
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Authorized Official
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Title or Position | ENROLLMENT MANAGER
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Name | MIXZA SANTA
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Credential |
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Telephone | 267-425-9233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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