Organization · NPI-2
Baker Pediatrics LLC
Pediatrics · Edgewater, NJ
NPI number1194487397
StatusActive
Last updated in NPPESAug 8, 2022
Details
- NPI
- 1194487397
- Entity type
- Organization (NPI-2)
- Legal business name
- Baker Pediatrics LLC
- Organization subpart
- No
- Enumeration date
- Oct 6, 2021
- Certification date
- Aug 8, 2022
- Last updated
- Aug 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 207R00000X | Internal Medicine | – | – |
Practice location
34 The PromenadeEdgewater, NJ 07020-2127
Phone 551-355-1200
Mailing address
34 The PromenadeEdgewater, NJ 07020-2127
Phone 551-355-1200 · Fax 551-355-1212
Authorized official
Zeyad Baker
President
2017793460
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