Provider Demographics
NPI:1942546106
Name:NORTH BERGEN PEDIATRICS
Entity Type:Organization
Organization Name:NORTH BERGEN PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMANZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-458-8000
Mailing Address - Street 1:2811 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2227
Mailing Address - Country:US
Mailing Address - Phone:973-458-8000
Mailing Address - Fax:973-458-8425
Practice Address - Street 1:2811 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-2227
Practice Address - Country:US
Practice Address - Phone:973-458-8000
Practice Address - Fax:973-458-8425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06599400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty