PEDIATRIC AND ADOLESCENT MEDICINE – NPI #1053461855
Pediatrics

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

Health Care Provider Taxonomy Code for Pediatrics

PEDIATRIC AND ADOLESCENT MEDICINE is a provider located in WEST LONG BRANCH, NJ. NPPES has assigned the NPI number 1053461855 to PEDIATRIC AND ADOLESCENT MEDICINE on January 12, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2080A0000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Adolescent Medicine

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PEDIATRIC AND ADOLESCENT MEDICINE below.

NPI Profile for
PEDIATRIC AND ADOLESCENT MEDICINE

NPI Number
1053461855
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PEDIATRIC AND ADOLESCENT MEDICINE
Primary location
223 MONMOUTH RD
WEST LONG BRANCH, NJ 07764-1029
Phone: (732) 229-4540 Fax: (732) 229-8689
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MAUREEN KINGSLEY
OFFICE MNG
Phone: (732) 229-4540
Updated
Identifiers

Identifiers for PEDIATRIC AND ADOLESCENT MEDICINE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNJ0238201
MEDICAIDNJ2003201
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080A0000X
- Pediatrics / Adolescent Medicine (Primary)		 NJ MA040400

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.