Provider Demographics
NPI:1588107874
Name:ELITE PEDIATRICS LLC
Entity type:Organization
Organization Name:ELITE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROULA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-794-8855
Mailing Address - Street 1:1 BROADWAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1842
Mailing Address - Country:US
Mailing Address - Phone:201-794-8855
Mailing Address - Fax:201-794-6988
Practice Address - Street 1:1 BROADWAY
Practice Address - Street 2:SUITE 303
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1842
Practice Address - Country:US
Practice Address - Phone:201-794-8855
Practice Address - Fax:201-794-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty