| Pediatric Multicare | |
|
525 Wanaque Ave Pompton Lakes NJ 07442-1843 | |
| (973) 685-4411 | |
| Not Available |
| Full Name | Pediatric Multicare |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 525 Wanaque Ave, Pompton Lakes, New Jersey |
| Authorized Official Name and Position | Vera Bennett (MANAGING PARTNER) |
| Authorized Official Contact | 9736854411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Multicare 525 Wanaque Ave Pompton Lakes NJ 07442-1843 Ph: (973) 685-4411 | Pediatric Multicare 525 Wanaque Ave Pompton Lakes NJ 07442-1843 Ph: (973) 685-4411 |
| NPI Number | 1700028438 |
|---|---|
| Provider Enumeration Date | 03/26/2009 |
| Last Update Date | 03/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700028438 | NPI | - | NPPES |
| 6171109 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MA05857400 (New Jersey) | Primary |
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