Provider Demographics
NPI:1457388688
Name:SBMC
Entity Type:Organization
Organization Name:SBMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-322-5690
Mailing Address - Street 1:532 E. BROAD STREET
Mailing Address - Street 2:WESTFIELD PEDIATRICS
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090
Mailing Address - Country:US
Mailing Address - Phone:908-232-8077
Mailing Address - Fax:908-232-8447
Practice Address - Street 1:532 E. BROAD STREET
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090
Practice Address - Country:US
Practice Address - Phone:908-232-8077
Practice Address - Fax:908-232-8447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05741300282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital