Holly City Pediatrics,PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA6269600 Issued in NJ

Legal business name

HOLLY CITY PEDIATRICS,PA

Practice address

10 East Main St Holly City Pediatrics
Suite a
Millville, NJ 08332

Phone

(856) 825-5932

Fax

(856) 825-4819

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Lily Serrano

Title

Office Manager

Phone

(856) 825-5932

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Michael Joseph Kinney, CRNP

  • Pediatric Nurse Practitioner
  • Sewell, NJ
  • NPI 1043511611
  NPD (past)
• Ketan R Patel, MD

  • Pediatrics Physician
  • Millville, NJ
  • NPI 1164508867
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334880000000",
    "number": "1801925466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 EAST MAIN ST HOLLY CITY PEDIATRICS",
            "address_2": "SUITE A",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "08332",
            "telephone_number": "856-825-5932",
            "fax_number": "856-825-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 EAST MAIN ST HOLLY CITY PEDIATRICS",
            "address_2": "SUITE A",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "08332",
            "telephone_number": "856-825-5932",
            "fax_number": "856-825-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY CITY PEDIATRICS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2012-04-20",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "LILY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-825-5932"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA6269600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7684801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hendricks House, Inc
• Hendricks House, Inc
• Michelle Hering, LPN
• June L. Higgins, APN
• Alciena Holley
• Home Link International Inc
• Shelby Anne Horton
• Housing Authority of the City of Millville
• Lauren Hresko
• Holly Huber, NP

• Pediatrics Physician in Millville, NJ
• Providers in Millville, 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 Apr 20, 2012; 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.