Galloway Pediatric Medical Day Care LLC

Primary specialty

Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X

License

018252 Issued in NJ

Legal business name

GALLOWAY PEDIATRIC MEDICAL DAY CARE LLC

Practice address

66 West Jimmie Leeds Road
Absecon, NJ 08201

Phone

(609) 748-2888

NPI assigned

May 9, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Eugene Ehrenfeld

Title

Member

Phone

(718) 755-4047

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pediatric Day Health Center at Galloway Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1457796930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LAUREL AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121217",
            "telephone_number": "718-755-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 WEST JIMMIE LEEDS ROAD",
            "city": "ABSECON",
            "state": "NJ",
            "postal_code": "08201",
            "telephone_number": "609-748-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLOWAY PEDIATRIC MEDICAL DAY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "EHRENFELD",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-755-4047",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": "NJ",
            "license": "018252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "018252",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Day Health Center at Galloway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Dunn, PHARMD
• Caitlin Faralli
• Diego M Fiorentino, DO FACP
• Grace Fiorentino, DO
• Robert A Fusco, BS
• Erika Gardner
• Genoa Healthcare LLC
• Lenise Racquel Graddy, D.C.
• Christopher Guishard I
• Heidi Hackett

• All providers in Absecon, NJ
• Medically Fragile Infants and Children Day Care in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.