Provider Demographics
NPI:1093978405
Name:VENTURE PEDIATRICS, LLC
Entity Type:Organization
Organization Name:VENTURE PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-957-9200
Mailing Address - Street 1:1275 HIGHWAY 35
Mailing Address - Street 2:UNIT # 6
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2040
Mailing Address - Country:US
Mailing Address - Phone:732-957-9200
Mailing Address - Fax:732-957-9203
Practice Address - Street 1:1275 HIGHWAY 35
Practice Address - Street 2:UNIT # 6
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2040
Practice Address - Country:US
Practice Address - Phone:732-957-9200
Practice Address - Fax:732-957-9203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07043100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty