Provider Demographics
NPI:1801957287
Name:PEDIATRIC ASSOCIATES OF WEST ESSEX, P.A.
Entity type:Organization
Organization Name:PEDIATRIC ASSOCIATES OF WEST ESSEX, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STECKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-575-8585
Mailing Address - Street 1:1129 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7127
Mailing Address - Country:US
Mailing Address - Phone:973-575-8585
Mailing Address - Fax:973-882-6914
Practice Address - Street 1:1129 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7127
Practice Address - Country:US
Practice Address - Phone:973-575-8585
Practice Address - Fax:973-882-6914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02390700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty