Provider Demographics
NPI:1689763906
Name:WASHINGTON AVENUE PEDIATRICS
Entity Type:Organization
Organization Name:WASHINGTON AVENUE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-373-3199
Mailing Address - Street 1:41 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-3313
Mailing Address - Country:US
Mailing Address - Phone:973-373-3199
Mailing Address - Fax:
Practice Address - Street 1:41 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3313
Practice Address - Country:US
Practice Address - Phone:973-373-3199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5661307Medicaid
NJ=========Medicare UPIN