Pediatric and Adolescent Medicine

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MA37398 Issued in NJ

Legal business name

PEDIATRIC AND ADOLESCENT MEDICINE

Practice address

223 Monmouth Rd
West Long Branch, NJ 07764-1029

Phone

(732) 229-4540

Fax

(732) 229-8689

NPI assigned

Jan 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Maureen E Kingsley

Title

Office MNG

Phone

(732) 229-4540

Specialties & licenses 2

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053461855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 MONMOUTH RD",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641029",
            "telephone_number": "732-229-4540",
            "fax_number": "732-229-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 MONMOUTH RD",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641029",
            "telephone_number": "732-229-4540",
            "fax_number": "732-229-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KINGSLEY",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MNG",
        "authorized_official_telephone_number": "732-229-4540",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA37398",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA040400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003201",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0238201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore A. Oshetsky, D.M.D.
• Doug Padron, ATC
• Gerlando V Parisi, M.D.
• Rinkal Patel
• Isabella Renee Pecoraro
• Ezgi Pehlivan, PA-C
• Margo Peters, R.N.
• Danielle Monti Pfeiffer, LPC
• Physicians for Alternative Medicine
• Brittany Nicole Piccillo

• Pediatric Adolescent Medicine Physician in West Long Branch, NJ
• Providers in West Long Branch, NJ by specialty
• Pediatric Adolescent Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.