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General NPI Number Information
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NPI Number | 1609245315
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Entity Type | Organization
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Legal Business Name | ROBBINSVILLE AND BORDENTOWN PEDIATRICS
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 231 CROSSWICKS RD STE 11
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City | BORDENTOWN
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State | NJ
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Zip | 08505-2602
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Country | US
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Telephone | 609-298-7204
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Fax | 609-298-0491
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Provider Business Mailing Address
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Address Line | 30 BELMONT CIR
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City | COLUMBUS
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State | NJ
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Zip | 08022-9714
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDEBT
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Name | MS. PRATHIBHA POTHARLANKA
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Credential | M.D.
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Telephone | 856-465-7728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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