MEDICARE: PEDIATRICS DAY AND NIGHT

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

General Provider Information

NPI Number	:	1790805786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRICS DAY AND NIGHT

Provider Business Mailing Address
First Line	:	1230 WHITEHORSE MERCERVILLE RD
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3814
Country	:	US
Telephone Number	:	609-581-1700
Fax Number	:	609-581-8472

Provider Business Practice Location Address
First Line	:	1230 WHITEHORSE MERCERVILLE RD
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3814
Country	:	US
Telephone Number	:	609-581-1700
Fax Number	:	609-581-8472

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LINDA TUCCILLO
Credential	:
Telephone Number	:	609-581-1700

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	03/06/2012

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