Provider Demographics
NPI:1841498177
Name:HEALTHY HORIZONS PEDIATRICS, PA
Entity type:Organization
Organization Name:HEALTHY HORIZONS PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYON
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-432-7337
Mailing Address - Street 1:620 CRANBURY RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4098
Mailing Address - Country:US
Mailing Address - Phone:732-432-7337
Mailing Address - Fax:
Practice Address - Street 1:620 CRANBURY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4098
Practice Address - Country:US
Practice Address - Phone:732-432-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-09
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07758500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0046761Medicaid
NJ0046761Medicaid