| Hawthorne Pediatrics, Llc | |
|
330 Lafayette Ave Hawthorne NJ 07506-2506 | |
| (973) 841-5112 | |
| (973) 826-5064 |
| Full Name | Hawthorne Pediatrics, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 330 Lafayette Ave, Hawthorne, New Jersey |
| Authorized Official Name and Position | Maria Jose Vasena Marengo (OWNER) |
| Authorized Official Contact | 9738415112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawthorne Pediatrics, Llc 330 Lafayette Ave Hawthorne NJ 07506-2506 Ph: (973) 841-5112 | Hawthorne Pediatrics, Llc 330 Lafayette Ave Hawthorne NJ 07506-2506 Ph: (973) 841-5112 |
| NPI Number | 1336525260 |
|---|---|
| Provider Enumeration Date | 08/03/2015 |
| Last Update Date | 08/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336525260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 25MA09694700 (New Jersey) | Primary |
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