Provider Demographics
NPI:1649490608
Name:CHILDREN'S HEALTH CENTER, LLC
Entity type:Organization
Organization Name:CHILDREN'S HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMBURELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-264-6070
Mailing Address - Street 1:2139 STATE ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1001
Mailing Address - Country:US
Mailing Address - Phone:732-264-6070
Mailing Address - Fax:732-264-6076
Practice Address - Street 1:2139 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1001
Practice Address - Country:US
Practice Address - Phone:732-264-6070
Practice Address - Fax:732-264-6076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
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
NJ=========OtherTIN