Provider Demographics
NPI:1255675393
Name:IPEDIATRICS
Entity Type:Organization
Organization Name:IPEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPUYT
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:973-663-1143
Mailing Address - Street 1:21 BOWLING GREEN PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-3200
Mailing Address - Country:US
Mailing Address - Phone:973-663-1143
Mailing Address - Fax:
Practice Address - Street 1:21 BOWLING GREEN PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-3200
Practice Address - Country:US
Practice Address - Phone:973-663-1143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty