Provider Demographics
NPI:1245392893
Name:THE HERBERT KANIA PEDIATRIC GROUP
Entity Type:Organization
Organization Name:THE HERBERT KANIA PEDIATRIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-986-2058
Mailing Address - Street 1:1900 UNION VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:NJ
Mailing Address - Zip Code:07421-3024
Mailing Address - Country:US
Mailing Address - Phone:845-986-2058
Mailing Address - Fax:845-986-7669
Practice Address - Street 1:1900 UNION VALLEY RD
Practice Address - Street 2:
Practice Address - City:HEWITT
Practice Address - State:NJ
Practice Address - Zip Code:07421-3024
Practice Address - Country:US
Practice Address - Phone:845-986-2058
Practice Address - Fax:845-986-7669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty