Candlewood Pediatrics

Organization Active NPI Pediatrics Physician · Wall, NJ

NPI 1134545429 · NPPES record last updated Apr 4, 2014

Key facts

NPI
1134545429
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
License
25MA06638500 (NJ)
Legal business name
CANDLEWOOD PEDIATRICS
Practice address
1540 Hwy. 138
Suite 105
Wall, NJ 07719
Phone
(732) 280-3100
Fax
(732) 280-3103
NPI assigned
Mar 11, 2014
Organization subpart
No

Authorized official

Name
Tatyana Shkolnaya, M.D.
Title
Proprietor/Medical Doctor
Phone
(732) 280-3100

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1540 Highway 138
Ste 105
Wall, NJ 07719
Phone (732) 280-3100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208000000X 25MA06638500 NJ Yes

Addresses

Primary practice location

1540 Hwy. 138
Suite 105
Wall, NJ 07719

Mailing address

1540 Hwy. 138
Suite 105
Wall, NJ 07719
Phone (732) 280-3100

Other identifiers

IdentifierTypeStateIssuer
1497729842OtherNJNPI

Other names

  • TATYANA SHKOLNAYA Doing business as

Other providers in Wall, NJ

All providers in Wall, NJ · Pediatrics Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.