Provider Demographics
NPI:1184847188
Name:LAMINGTON PEDIATRICS, PC
Entity Type:Organization
Organization Name:LAMINGTON PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PURNACHANDER
Authorized Official - Middle Name:R
Authorized Official - Last Name:SIRIKONDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:201-487-5018
Mailing Address - Street 1:304 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-487-5018
Mailing Address - Fax:201-487-5020
Practice Address - Street 1:101 PROSPECT AVE, 1C
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-487-5018
Practice Address - Fax:201-487-5020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67533208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8274509Medicaid