Provider Demographics
NPI:1235479544
Name:CASIA PEDIATRICS LLC
Entity type:Organization
Organization Name:CASIA PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-798-6161
Mailing Address - Street 1:67 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2126
Mailing Address - Country:US
Mailing Address - Phone:201-798-6161
Mailing Address - Fax:201-798-0432
Practice Address - Street 1:67 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2126
Practice Address - Country:US
Practice Address - Phone:201-798-6161
Practice Address - Fax:201-798-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty