Provider Demographics
NPI:1073804233
Name:GLOBAL PEDIATRICS &FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:GLOBAL PEDIATRICS &FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-432-7777
Mailing Address - Street 1:7 AUER COURT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816
Mailing Address - Country:US
Mailing Address - Phone:732-432-7777
Mailing Address - Fax:732-432-9030
Practice Address - Street 1:7 AUER COURT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-432-7777
Practice Address - Fax:732-432-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07414700207Q00000X
NJ615462080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8869405Medicaid
NJ058718Medicare PIN
NJH64379Medicare UPIN