NPI 1073538658

Pedi Doc, P.A.

Organisation Preferred Provider Organization Perth Amboy, NJ

Practice location

Address: 205 Smith St Suite D, Perth Amboy, NJ 08861-4323
Phone: (732) 697-1600
Mailing address: 22 Ball St Suite 100, Irvington, NJ 07111-3521

Authorised official

Name: Bernier Lauredan
Title: Medical Director
Phone: (973) 371-1600

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 25MA05388700 (NJ)

Other Preferred Provider Organization providers in New Jersey →

Registry record

NPI: 1073538658
Entity type: Organization
NPI issued: 13 Jul 2006
Record last updated: 22 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.