Provider Demographics
NPI:1184089849
Name:SEAHORSE PEDIATRICS LLC
Entity type:Organization
Organization Name:SEAHORSE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHABNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGHSOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-440-7211
Mailing Address - Street 1:142 HIGHWAY 35
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1876
Mailing Address - Country:US
Mailing Address - Phone:732-440-7211
Mailing Address - Fax:732-440-7211
Practice Address - Street 1:142 HIGHWAY 35
Practice Address - Street 2:SUITE 105
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1876
Practice Address - Country:US
Practice Address - Phone:732-440-7211
Practice Address - Fax:732-440-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty