Bayshore Pediatric Association LLC

Organization Active NPI Pediatric Adolescent Medicine Physician · Holmdel, NJ

NPI 1720109952 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1720109952
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Adolescent Medicine Physician 2080A0000X
Legal business name
BAYSHORE PEDIATRIC ASSOCIATION LLC
Practice address
717 N Beers St
Suite 1C
Holmdel, NJ 07733-1524
Phone
(732) 888-0010
Fax
(732) 888-0012
NPI assigned
Apr 3, 2007
Organization subpart
No

Authorized official

Name
Dr. Jennifer Duck Engel, M.D.
Title
Operating Manager
Phone
(732) 888-0010

National Provider Directory

Locations

717 N Beers St
Ste 1C
Holmdel, NJ 07733
Phone (732) 377-2580

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2080A0000X Yes

Addresses

Primary practice location

717 N Beers St
Suite 1C
Holmdel, NJ 07733-1524

Mailing address

717 N Beers St
Suite 1C
Holmdel, NJ 07733-1524
Phone (732) 888-0010

Other providers in Holmdel, NJ

All providers in Holmdel, NJ · Pediatric Adolescent Medicine Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.