MEDICARE: VENTNOR PEDIATRICS INC.

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	2080A0000X	Pediatric Adolescent Medicine 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
2	2255928001	OTHER	NJ	AMERIHEALTH HMO/PPO

General Provider Information

NPI Number	:	1740230952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENTNOR PEDIATRICS INC.

Provider Business Mailing Address
First Line	:	6601 VENTNOR AVE
Second Line	:	SUITE 14
City	:	VENTNOR
State	:	NJ
Zip	:	08406-2167
Country	:	US
Telephone Number	:	609-487-6509
Fax Number	:	609-487-6508

Provider Business Practice Location Address
First Line	:	6601 VENTNOR AVE
Second Line	:	SUITE 14
City	:	VENTNOR
State	:	NJ
Zip	:	08406-2167
Country	:	US
Telephone Number	:	609-487-6507
Fax Number	:	609-487-6508

Authorized Official
Title or Position	:	OWNER
Name	:	EMIOLA ASEMOTA
Credential	:	M.D.
Telephone Number	:	609-487-6507

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	01/02/2014

Similar Medicare Providers

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Practice Location Address:

6601 VENTNOR AVE , SUITE 14
VENTNOR, NJ
08406-2167

Practice Phone: 609-487-6507
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Practice Location Address:

6601 VENTNOR AVE , TROY AVENUE ST14
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Practice Fax:

1689961401 — VENTNOR PEDIATRICS INC
Practice Location Address:

6601 VENTNOR AVE , SUITE #14
VENTNOR CITY, NJ
08406-2167

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1518372424 — SHORE HELP, LLC
Practice Location Address:

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1699771170 — REHABCLINICS SPT, INC.
Practice Location Address:

6307 VENTNOR AVE
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08406

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Directions to “VENTNOR PEDIATRICS INC. ” Practice Location

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