Provider Demographics
NPI:1588816532
Name:NORTHERN VALLEY PEDIATRICS, LLC
Entity Type:Organization
Organization Name:NORTHERN VALLEY PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHILPA
Authorized Official - Middle Name:ASHOK
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-564-7377
Mailing Address - Street 1:463 LIVINGSTON ST
Mailing Address - Street 2:UNIT 204
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1344
Mailing Address - Country:US
Mailing Address - Phone:201-564-7377
Mailing Address - Fax:201-564-7379
Practice Address - Street 1:463 LIVINGSTON ST
Practice Address - Street 2:UNIT 204
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648-1344
Practice Address - Country:US
Practice Address - Phone:201-564-7377
Practice Address - Fax:201-564-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty