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General NPI Number Information
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NPI Number | 1346275849
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ASSOCIATES OF CENTRAL JERSEY PA
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 326 MAIN ST
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City | METUCHEN
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State | NJ
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Zip | 08840-2431
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Country | US
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Telephone | 732-767-0630
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Fax | 732-767-3070
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Provider Business Mailing Address
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Address Line | 326 MAIN ST
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City | METUCHEN
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State | NJ
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Zip | 08840-2431
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Country | US
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Telephone | 732-767-0630
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Fax | 732-767-3070
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JANET V SPANKO
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Credential | RN, OM
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Telephone | 732-767-0526
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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 | MA 39053
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA 48133
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA 48162
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License Number State | NJ
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