Provider Demographics
NPI:1609019975
Name:MIGUELINO AND DAVID PEDIATRIC ASSOCIATES,LLC
Entity type:Organization
Organization Name:MIGUELINO AND DAVID PEDIATRIC ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGUELINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-888-0777
Mailing Address - Street 1:717 N BEERS ST
Mailing Address - Street 2:SUITE 1-F
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1524
Mailing Address - Country:US
Mailing Address - Phone:732-888-0777
Mailing Address - Fax:732-888-0880
Practice Address - Street 1:717 N BEERS ST
Practice Address - Street 2:SUITE 1-F
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1524
Practice Address - Country:US
Practice Address - Phone:732-888-0777
Practice Address - Fax:732-888-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty