Provider Demographics
NPI:1508938291
Name:RUTHERFORD PEDIATRICS&PEDIATRIC PULMONOLOGY P.C.
Entity Type:Organization
Organization Name:RUTHERFORD PEDIATRICS&PEDIATRIC PULMONOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BECZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-842-0501
Mailing Address - Street 1:338 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1563
Mailing Address - Country:US
Mailing Address - Phone:201-842-0501
Mailing Address - Fax:201-842-9190
Practice Address - Street 1:338 UNION AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1563
Practice Address - Country:US
Practice Address - Phone:201-842-0501
Practice Address - Fax:201-842-9190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA061270002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty