Healthy Pediatrics at Old Bridge, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

HEALTHY PEDIATRICS AT OLD BRIDGE, LLC

Practice address

3 Athens Ave
South Amboy, NJ 08879-2401

Phone

(732) 952-8400

Fax

(984) 260-3810

NPI assigned

Feb 14, 2024

Last updated

Feb 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia Manfredonia, MDNPI 1639154180

Title

Owner

Phone

(973) 650-0059

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Estrada Manfredonia, MD

  • Pediatrics Physician
  • South Amboy, NJ
  • NPI 1639154180
  NPD (past) Authorized official

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1073378519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ATHENS AVE",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792401",
            "telephone_number": "973-650-0059",
            "fax_number": "984-260-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ATHENS AVE",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792401",
            "telephone_number": "732-952-8400",
            "fax_number": "984-260-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY PEDIATRICS AT OLD BRIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "MANFREDONIA",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-650-0059",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in South Amboy, NJ
• Providers in South Amboy, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.