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General NPI Number Information
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NPI Number | 1831379841
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Entity Type | Organization
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Legal Business Name | UNION COUNTY PEDIATRICS GROUP INC
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 817 RAHWAY AVE
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City | ELIZABETH
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State | NJ
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Zip | 07202-2212
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Country | US
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Telephone | 908-353-5750
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Fax | 908-349-3064
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Provider Business Mailing Address
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Address Line | 817 RAHWAY AVE
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City | ELIZABETH
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State | NJ
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Zip | 07202-2212
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Country | US
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Telephone | 908-353-5750
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Fax | 908-349-3064
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Authorized Official
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Title or Position | MANAGER
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Name | MR. VISHAL GANDHI
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Credential |
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Telephone | 908-353-5750
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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 | 25MA03959800
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License Number State | NJ
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