Provider Demographics
NPI:1780717736
Name:BURGHER AND MARON PEDIATRICS
Entity type:Organization
Organization Name:BURGHER AND MARON PEDIATRICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BHAVNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-692-6000
Mailing Address - Street 1:2950 COLLEGE DRIVE
Mailing Address - Street 2:UNIT 2 C
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360
Mailing Address - Country:US
Mailing Address - Phone:856-692-6000
Mailing Address - Fax:856-692-0609
Practice Address - Street 1:2950 COLLEGE DRIVE
Practice Address - Street 2:UNIT 2 C
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-692-6000
Practice Address - Fax:856-692-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06289200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty