Provider Demographics
NPI:1649335290
Name:ABC PEDIATRIC ASSOCIATES, LLC
Entity type:Organization
Organization Name:ABC PEDIATRIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-477-8988
Mailing Address - Street 1:131 DRUM POINT RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6221
Mailing Address - Country:US
Mailing Address - Phone:732-477-8988
Mailing Address - Fax:732-477-8780
Practice Address - Street 1:131 DRUM POINT RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6221
Practice Address - Country:US
Practice Address - Phone:732-477-8988
Practice Address - Fax:732-477-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6981704Medicaid