Provider Demographics
NPI:1144081852
Name:KINTIROGLOU PEDIATRICS LLC
Entity type:Organization
Organization Name:KINTIROGLOU PEDIATRICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KINTIROGLOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-243-0002
Mailing Address - Street 1:7 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1402
Mailing Address - Country:US
Mailing Address - Phone:973-295-6226
Mailing Address - Fax:
Practice Address - Street 1:745 NORTHFIELD AVE STE 7
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1136
Practice Address - Country:US
Practice Address - Phone:973-243-0002
Practice Address - Fax:855-274-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty