Provider Demographics
NPI:1073741856
Name:CLIFTON PEDIATRICS, PTR
Entity Type:Organization
Organization Name:CLIFTON PEDIATRICS, PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELIH
Authorized Official - Middle Name:
Authorized Official - Last Name:SARIGUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-249-8211
Mailing Address - Street 1:296 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2223
Mailing Address - Country:US
Mailing Address - Phone:973-249-8211
Mailing Address - Fax:973-249-8611
Practice Address - Street 1:296 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2223
Practice Address - Country:US
Practice Address - Phone:973-249-8211
Practice Address - Fax:973-249-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA066237002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7608403Medicaid