Provider Demographics
NPI:1932231719
Name:MILLBURN PEDIATRICS PA
Entity Type:Organization
Organization Name:MILLBURN PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:GHUZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-912-0554
Mailing Address - Street 1:159 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1849
Mailing Address - Country:US
Mailing Address - Phone:973-912-0155
Mailing Address - Fax:973-912-8714
Practice Address - Street 1:159 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1849
Practice Address - Country:US
Practice Address - Phone:973-912-0155
Practice Address - Fax:973-912-8714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty