=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720341902
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BETTER PEDIATRICS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2012
-----------------------------------------------------
Last Update Date | 06/21/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2206 ROUTE 130
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902-4805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-422-1420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2206 ROUTE 130
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902-4805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-422-1420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ELIZABETH ESTEROV
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 732-422-1420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | MA72047
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------