Pediatric Multicare

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

25MA05857400 Issued in NJ

Legal business name

PEDIATRIC MULTICARE

Practice address

525 Wanaque Ave
Pompton Lakes, NJ 07442-1843

Phone

(973) 685-4411

NPI assigned

Mar 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Vera Bennett, MD

Title

Managing Partner

Phone

(973) 685-4411

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238025600000",
    "number": "1700028438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WANAQUE AVE",
            "city": "POMPTON LAKES",
            "state": "NJ",
            "postal_code": "074421843",
            "telephone_number": "973-685-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WANAQUE AVE",
            "city": "POMPTON LAKES",
            "state": "NJ",
            "postal_code": "074421843",
            "telephone_number": "973-685-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MULTICARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-03-26",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "973-685-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "25MA05857400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6171109",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Pankey
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• Pathways Counseling Center Inc.
• Pathways Counseling Center Inc.
• Pathways Counseling Center Inc.
• Janice M. Peters, PH.D.
• Planned Parenthood of Metropolitan New Jersey
• Pompton Anesthesia Associates
• Pompton Lake Pharmacy LLC
• Pompton Lakes Board of Education

• Primary Care Clinic/Center in Pompton Lakes, NJ
• Providers in Pompton Lakes, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.