Provider Demographics
NPI:1609245315
Name:ROBBINSVILLE AND BORDENTOWN PEDIATRICS
Entity Type:Organization
Organization Name:ROBBINSVILLE AND BORDENTOWN PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEBT
Authorized Official - Prefix:MS
Authorized Official - First Name:PRATHIBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:POTHARLANKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-465-7728
Mailing Address - Street 1:30 BELMONT CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NJ
Mailing Address - Zip Code:08022-9714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:231 CROSSWICKS RD STE 11
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2602
Practice Address - Country:US
Practice Address - Phone:609-298-7204
Practice Address - Fax:609-298-0491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty