MEDICARE: SOUTH JERSEY DEVELOPMENTAL 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	2080P0006X	Developmental - Behavioral Pediatrics Physician

General Provider Information

NPI Number	:	1790669398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH JERSEY DEVELOPMENTAL PEDIATRICS LLC

Provider Business Mailing Address
First Line	:	900 KINGS HWY N STE 300
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 KINGS HWY N STE 300
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-1516
Country	:	US
Telephone Number	:	856-202-7081
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. DANIELA ZISKIND
Credential	:	MD
Telephone Number	:	856-202-7081

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	08/05/2025

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