Provider Demographics
NPI:1013112507
Name:CHATHAM PEDIATRICS, LLC
Entity Type:Organization
Organization Name:CHATHAM PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELSIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-465-4511
Mailing Address - Street 1:12 PARROTT MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2744
Mailing Address - Country:US
Mailing Address - Phone:973-635-4511
Mailing Address - Fax:973-701-1520
Practice Address - Street 1:12 PARROTT MILL RD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2744
Practice Address - Country:US
Practice Address - Phone:973-635-4511
Practice Address - Fax:973-701-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ05279000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty