Provider Demographics
NPI:1538209408
Name:SILVERTON PEDIATRICS LLC
Entity type:Organization
Organization Name:SILVERTON PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NELLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-255-7553
Mailing Address - Street 1:2446 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8182
Mailing Address - Country:US
Mailing Address - Phone:732-255-7553
Mailing Address - Fax:732-255-8901
Practice Address - Street 1:2446 CHURCH RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8182
Practice Address - Country:US
Practice Address - Phone:732-255-7553
Practice Address - Fax:732-255-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty