MERIDIAN PEDIATRIC SURGICAL ASSOCIATES, P.C. (NPI# 1699937961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699937961 |
| Entity Type | Organization |
| Organization Name | MERIDIAN PEDIATRIC SURGICAL ASSOCIATES, P.C. |
| Practice Address |
4 Industrial Way W Ste 100 Eatontown NJ 07724-4239 |
| Practice Telephone | 7329350407 |
| Practice Fax Number | 7329350757 |
| Mailing Telephone | 7329350407 |
| Mailing Fax Number | 7329350757 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2019-03-21 |
| Authorized Official Name | JAMES CLARKE (DIRECTOR) |
| Authorized Official Telephone | 7329748404 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
4 INDUSTRIAL WAY W STE 100 |
| City | EATONTOWN |
| State | NJ |
| Zip Code | 07724-4239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719788 | Zsanae Lewis | Driver | 1 Main St Unit 401, Eatontown, NJ 07724 | 2019-06-18 |
| 1417419169 | Refocus | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 613 Hope Road, Building 5 and 2, Eatontown, NJ 07724 | 2019-04-02 |
| 1215401575 | Angela Fordham-lewis | Day Training/Habilitation Specialist | 613 Hope Road, Building #2, Eatontown, NJ 07724 | 2019-01-18 |
| 1174094312 | Patti Kousoulis | Counselor | 10 Industrial Way East, Eatontown, NJ 07724 | 2018-12-16 |
| 1649745589 | Jersey Shore Dental Spa LLC | Dentist | 613 Hope Road Building 5, Eatontown, NJ 07724 | 2018-10-08 |
| 1487135448 | A2z Diagnostics LLC | Pathology | 6 Industrial Way W Ste F19, Eatontown, NJ 07724 | 2018-08-27 |
| 1942708268 | Elyce Jackson | Counselor | 10 Industrial Way, Eatontown, NJ 07724 | 2018-02-01 |
| 1477065894 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 249, Eatontown, NJ 07724 | 2017-10-25 |
| 1639681059 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 277, Eatontown, NJ 07724 | 2017-10-25 |
| 1669998100 | Seacrest Recovery Center North Jersey, LLC | Psychologist | 162 Highway 35, Eatontown, NJ 07724 | 2017-08-16 |
| Find all providers in zip 07724 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104064971 | Victoriya Staab | Surgery | 4 Industrial Way, Suite 100, Eatontown, NJ 07724-4238 | 2009-01-31 |
| 1205812005 | Saad A Saad | Surgery | 615 Hope Rd, Bld 1 A, Eatontown, NJ 07724-1277 | 2005-12-22 |
| 1932223203 | Saad A Saad Md Pa | Surgery | 615 Hope Rd, Eatontown, NJ 07724-1277 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487851366 | Joseph Sujai Udomsaph | Surgery | 7 Baltic St, Edison, NJ 08820-2724 | 2007-07-02 |
| 1851355317 | Saverio Joseph Panzarino | Surgery | 53 Sentinel Dr, Basking Ridge, NJ 07920-4231 | 2006-04-13 |
| 1417591645 | Stc Pediatrics LLC | Surgery | 100 Kings Way E Ste C, Sewell, NJ 08080-2238 | 2019-10-31 |
| 1083939573 | Jennifer M Murphy | Surgery | 100 Madison Avenue, Farris Building, Third Floor, Morristown, NJ 07960 | 2010-03-29 |
| 1649463696 | Cooper Surgical Asscociates | Surgery | 3 Cooper Plz, Suite 411, Camden, NJ 08103-1438 | 2007-08-23 |
| 1528265279 | Joelle Pierre | Surgery | One Robert Wood Johnson Place, Department of Pediatric Surgery, New Brunswick, NJ 08903 | 2007-06-27 |
| 1659406957 | Rutgers Health-rwj Pediatric Neurosurgery | Surgery | 125 Paterson St, Umdnj Rwj Pediatric Neuosurgery Suite 2100, New Brunswick, NJ 08901-1962 | 2007-02-23 |
| 1982773545 | Frederick Alexander | Surgery | 140 Route 17 North, Suite 321, Paramus, NJ 07652 | 2006-11-07 |
| 1255400099 | Randall Burd | Surgery | 125 Paterson St, Clinical Academic Building - Suite 4100, New Brunswick, NJ 08901-1962 | 2006-11-07 |
| 1982788477 | Children's Surgical Associates of New Jersey Inc | Surgery | 1012 Laurel Oak Rd, Suite 1, Voorhees, NJ 08043-3505 | 2006-10-24 |
| Find all providers with the same taxonomy | ||||
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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.