Provider Demographics
NPI:1114064110
Name:CHILTON PEDIATRICS LLC
Entity Type:Organization
Organization Name:CHILTON PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DANILO
Authorized Official - Middle Name:MAGALLANES
Authorized Official - Last Name:GUINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-659-0429
Mailing Address - Street 1:144 CHILTON STREET
Mailing Address - Street 2:CHILTON PEDIATRICS LLC
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1448
Mailing Address - Country:US
Mailing Address - Phone:908-659-0429
Mailing Address - Fax:908-659-1559
Practice Address - Street 1:144 CHILTON STREET
Practice Address - Street 2:CHILTON PEDIATRICS LLC
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1448
Practice Address - Country:US
Practice Address - Phone:908-659-0429
Practice Address - Fax:908-659-1559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANILO M GUINTO MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57959208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1598702094OtherINDIVIDUAL NPI
NJ6808107Medicaid