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General NPI Number Information
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NPI Number | 1962532010
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Entity Type | Organization
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Legal Business Name | WEST ORANGE PEDIATRICS
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 81 NORTHFIELD AVE
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5342
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Country | US
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Telephone | 973-324-5437
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Fax | 973-324-0356
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Provider Business Mailing Address
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Address Line | 81 NORTHFIELD AVE
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5342
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Country | US
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Telephone | 973-324-5437
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Fax | 973-324-0356
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABRAHAM THOMAS
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Credential | MD
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Telephone | 973-324-5437
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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 | MA62740
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License Number State | NJ
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