Provider Demographics
NPI:1760666036
Name:PEDIATRIC CENTER OF SOMERSET LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:PEDIATRIC CENTER OF SOMERSET LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SPEESLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-764-0004
Mailing Address - Street 1:PO BOX 6086
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08875-6086
Mailing Address - Country:US
Mailing Address - Phone:732-764-0004
Mailing Address - Fax:732-658-4543
Practice Address - Street 1:1440 HOW LN STE 2F
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4600
Practice Address - Country:US
Practice Address - Phone:732-764-0004
Practice Address - Fax:732-960-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine