Provider Demographics
NPI:1790669398
Name:SOUTH JERSEY DEVELOPMENTAL PEDIATRICS LLC
Entity type:Organization
Organization Name:SOUTH JERSEY DEVELOPMENTAL PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZISKIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-202-7081
Mailing Address - Street 1:900 KINGS HWY N STE 300
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 KINGS HWY N STE 300
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1516
Practice Address - Country:US
Practice Address - Phone:856-202-7081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty