Provider Demographics
NPI:1144403163
Name:CONVENIENT PEDIATRICS
Entity Type:Organization
Organization Name:CONVENIENT PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-329-8215
Mailing Address - Street 1:613 RIDGE RD
Mailing Address - Street 2:STE:104
Mailing Address - City:MONMOUTH JCT
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2630
Mailing Address - Country:US
Mailing Address - Phone:732-329-8215
Mailing Address - Fax:
Practice Address - Street 1:613 RIDGE RD
Practice Address - Street 2:STE:104
Practice Address - City:MONMOUTH JCT
Practice Address - State:NJ
Practice Address - Zip Code:08852-2630
Practice Address - Country:US
Practice Address - Phone:732-329-8215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06420900261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care