Provider Demographics
NPI:1912013731
Name:CITYHEIGHTS PEDIATRICS
Entity Type:Organization
Organization Name:CITYHEIGHTS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:
Authorized Official - Last Name:CENON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-866-7740
Mailing Address - Street 1:511 22ND ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-3500
Mailing Address - Country:US
Mailing Address - Phone:201-866-7740
Mailing Address - Fax:201-866-6610
Practice Address - Street 1:511 22ND ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3500
Practice Address - Country:US
Practice Address - Phone:201-866-7740
Practice Address - Fax:201-866-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty