CENTER FOR PEDIATRICS ADOLESCENT AND ADULT MEDICINE OF SNJ PA (NPI# 1467508796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467508796 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PEDIATRICS ADOLESCENT AND ADULT MEDICINE OF SNJ PA |
| Practice Address |
12000 Lincoln Dr W Suite 311 Marlton NJ 08053-3402 |
| Mailing Address |
12000 Lincoln Dr W Ste 311 Marlton NJ 08053-3405 |
| Practice Telephone | 8569858100 |
| Practice Fax Number | 8569858374 |
| Mailing Telephone | 8569858100 |
| Mailing Fax Number | 8569858374 |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAY MIRMANESH (PRESIDENT) |
| Authorized Official Telephone | 8569858100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 25MA05186900 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
12000 LINCOLN DR W SUITE 311 |
| City | MARLTON |
| State | NJ |
| Zip Code | 08053-3402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558366781 | Bryan C Russell | Chiropractor | 12000 Lincoln Dr W, Suite 304, Marlton, NJ 08053-3402 | 2005-06-15 |
| 1114267721 | The Eb Wellness Center | Social Worker | 12000 Lincoln Dr W, Suite 405, Marlton, NJ 08053-3402 | 2013-02-18 |
| 1760756654 | Dorothea Neuber | Social Worker | 12000 Lincoln Dr W, Ste 407, Marlton, NJ 08053-3402 | 2012-02-24 |
| 1528365186 | Unity Care Medical Group, LLC | Family Medicine | 12000 Lincoln Dr W, Suite 311, Marlton, NJ 08053-3402 | 2011-02-17 |
| 1972782704 | Center for Neurologic Specialty | Psychiatry & Neurology | 12000 Lincoln Dr W, Suite 204, Marlton, NJ 08053-3402 | 2007-10-29 |
| 1528259264 | Stephen Falkowski, Do Pa | Family Medicine | 12000 Lincoln Dr W, Suite 309, Marlton, NJ 08053-3402 | 2007-08-07 |
| 1013115690 | Nadia Chaudhry | Legal Medicine | 12000 Lincoln Dr W, Marlton, NJ 08053-3402 | 2007-07-05 |
| 1083751291 | Kathleen Marie Dean | Social Worker | 12000 Lincoln Dr W, Suite 407, Marlton, NJ 08053-3402 | 2007-01-30 |
| 1922159425 | Carol P Bilofsky | Social Worker | 12000 Lincoln Dr W, Site 407, Marlton, NJ 08053-3402 | 2007-01-13 |
| 1770665242 | Charles Graham | Social Worker | 12000 Lincoln Dr W, Suite 407 Pavilions At Greentree, Marlton, NJ 08053-3402 | 2006-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619509288 | South Jersey Coping Clinic | Counselor | 525 Nj Route 73 South, Ste 306, Marlton, NJ 08053 | 2020-02-11 |
| 1780216952 | Aba Residential | Psychologist | 7 Cooper Ave Suit A, Marlton, NJ 08053 | 2020-02-06 |
| 1003447400 | Forrest Mark Waterman | Optometrist | 928 Nj-73, Evesham Township, NJ 08053 | 2020-02-04 |
| 1124666862 | Bh Brightview Greentree Opco, LLC | Alzheimer Center (Dementia Center) | 170 Grrentree Road, Marlton, NJ 08053 | 2019-12-12 |
| 1780226597 | Cassandra Ann Pistorius | Counselor | 77 Lakeside Dr, Marlton, NJ 08053 | 2019-10-14 |
| 1265099741 | Jessica Strassle | Occupational Therapist | 751 Nj-73, Suite 1, Marlton, NJ 08053 | 2019-05-21 |
| 1972169902 | Jefferson University Radiology Associates, LLC | Radiology | 999 Nj-73, # 101, Marlton, NJ 08053 | 2019-05-15 |
| 1235692120 | Liberty Corner Surgical Center At Marlton LLC | Clinic/Center | 95 Marlton Pike West, Marlton, NJ 08053 | 2019-04-09 |
| 1063995769 | Genesis Counseling Center, Inc. | Counselor | 2003 C Lincoln Dr. W., Marlton, NJ 08053 | 2018-09-10 |
| 1659853414 | Erika V Colbert | Nurse Practitioner | 1 Eves Drive 134, 134, Marlton, NJ 08053 | 2018-08-29 |
| Find all providers in zip 08053 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780811034 | John C. Mirmanesh | Pediatrics | 12000 Lincoln Dr W Ste 311, Marlton, NJ 08053-3405 | 2009-06-14 |
| 1679669618 | Racine B Zechowy | Pediatrics | 127 Church Rd Ste 800, Marlton, NJ 08053-9425 | 2006-10-05 |
| 1174536783 | Advocare, LLC | Pediatrics | 525 Rt. 73 South Evesham Commons 102, Marlton, NJ 08053 | 2006-08-14 |
| 1316904410 | Benjamin A Rosenblum | Pediatrics | 301 Old Marlton Pike W, Suite 1, Marlton, NJ 08053-2076 | 2006-05-01 |
| 1356331482 | Ramesh Ragothaman | Pediatrics | 528 Lippincott Dr, Marlton, NJ 08053-4805 | 2005-10-28 |
| 1134119811 | Bryan H Levey | Pediatrics | 475 Old Marlton Pike W, Suite 4, Marlton, NJ 08053-2098 | 2005-10-25 |
| 1962492959 | Aditee D Leszkowicz | Pediatrics | 500 Lippincott Dr, Marlton, NJ 08053-4802 | 2005-10-21 |
| 1356988661 | Peds Purpose LLC | Pediatrics | 525 Route 73 N Ste 104, Marlton, NJ 08053-3422 | 2019-12-05 |
| 1902126121 | Thomas Joseph Killeen IIi | Pediatrics | 402 Lippincott Dr, Marlton, NJ 08053-4112 | 2010-06-10 |
| 1407974512 | Integrated Childrens Health | Pediatrics | 528 Lippincott Dr, Marlton, NJ 08053-4805 | 2007-03-27 |
| Find all providers in MARLTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.