Provider Demographics
NPI:1932473840
Name:JUST KIDZ PEDIATRICS
Entity Type:Organization
Organization Name:JUST KIDZ PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JADHAV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-279-2294
Mailing Address - Street 1:715 BROADWAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-3406
Mailing Address - Country:US
Mailing Address - Phone:973-279-2294
Mailing Address - Fax:973-279-7341
Practice Address - Street 1:715 BROADWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-3406
Practice Address - Country:US
Practice Address - Phone:973-279-2294
Practice Address - Fax:973-279-7341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08647400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty