MEDICARE: ARKUS POLITIS PEDIATRICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053480525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKUS POLITIS PEDIATRICS, LLC

Provider Business Mailing Address
First Line	:	3526 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3448
Country	:	US
Telephone Number	:	201-653-5933
Fax Number	:	201-653-3930

Provider Business Practice Location Address
First Line	:	3526 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3448
Country	:	US
Telephone Number	:	201-653-5933
Fax Number	:	201-653-3930

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. GERRY WILSON
Credential	:
Telephone Number	:	201-653-5936

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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