Montclair Pediatrics
Pediatrics, Adolescent Medicine in Montclair, NJ. Organization (NPI-2).
NPI number1073679932
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1073679932
- Entity type
- Organization (NPI-2)
- Legal business name
- Montclair Pediatrics
- Organization subpart
- No
- Enumeration date
- Dec 28, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080A0000X | Pediatrics, Adolescent Medicine | – | – | Yes |
Practice location
73 Park StMontclair, NJ 07042-2903
Phone 973-746-7375 · Fax 973-746-6772
Mailing address
73 Park StMontclair, NJ 07042-2903
Phone 973-746-7375 · Fax 973-746-6772
Authorized official
Edward D. Rigtrup
Owner
9737467375
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