PROVIDENCE PEDIATRIC MEDICAL DAYCARE, INC. (NPI# 1720247091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720247091 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PEDIATRIC MEDICAL DAYCARE, INC. |
| Practice Address |
35 S Annapolis Ave Atlantic City NJ 08401-5927 |
| Mailing Address |
411 Commerce Ln West Berlin NJ 08091-9254 |
| Practice Telephone | 6093452340 |
| Practice Fax Number | 6093453021 |
| Mailing Telephone | 8567537763 |
| Mailing Fax Number | 8567537714 |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |
| Authorized Official Name | MS. LEEANNA ROMAN (PRESIDENT) |
| Authorized Official Telephone | 8567537763 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM3000X |
Clinic/Center Specialization: Medically Fragile Intants and Children Day Care |
018200 | NJ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083765010 | Providence Pediatric Medical Daycare, Inc. | Clinic/Center | 1000 Atlantic Ave, Camden D, 2nd Floor, Camden, NJ 08104-1132 | 2007-01-16 |
| Street Address |
35 S ANNAPOLIS AVE |
| City | ATLANTIC CITY |
| State | NJ |
| Zip Code | 08401-5927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133175 | Kristy Liekfet | Nurse Practitioner | Atlanticare Apg Palliative Care, 1925 Pacific Ave. 1st Flr, Atlantic City, NJ 08401 | 2020-10-29 |
| 1346716834 | Q Pharma Inc | Non-Pharmacy Dispensing Site | 3830 Atlantic Avenue, Atlantic City, NJ 08401 | 2018-10-23 |
| 1922597947 | Kara Nicole Bonsera | Nurse Practitioner | 1801 Atlantic Ave Fl 3, Atlantic City, NJ 08401 | 2018-05-04 |
| 1437605656 | John Brooks Recovery Center, A New Jersey Non-profit Corporation | Clinic/Center | 1931 Bacharach Blvd, Atlantic City, NJ 08401 | 2016-08-28 |
| 1265874051 | Mary K. Wilsbach | Social Worker | 1401 Atlantic Ave.suite 2200, Healthplex, Atlanticare Ambulatory Care Services;, Atlantic City, NJ 08401 | 2013-07-23 |
| 1326388133 | Atlantic City Board of Education | Local Education Agency (LEA) | 1300 Atlantic Avenue, 5th Floor, Atlantic City, NJ 08401 | 2013-02-15 |
| 1972818656 | Mittal H. Patel | Pharmacist | 1723 Pacific Ave, Atlantic City, NJ 08401 | 2010-08-18 |
| 1689803900 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2109 Atlantic Ave., Ste. 1016, Atlantic City, NJ 08401 | 2009-07-08 |
| 1750536850 | Joel G. Weiss | Dentist | 3822 Ventnor Ave, Atlantic City, NJ 08401 | 2008-11-18 |
| 1982879631 | Angela Butcher | Nurse's Aide | 401 North Martin Luthur King Blvd, Atlantic City, NJ 08401 | 2008-04-24 |
| Find all providers in zip 08401 | ||||
| Taxonomy Code | 261QM3000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medically Fragile Intants and Children Day Care |
| An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841581626 | Health Care Benefit Services, LLC | Clinic/Center | 29 N Vermont Ave, Atlantic City, NJ 08401-5561 | 2011-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063913143 | The Village Child Care Center LLC | Clinic/Center | 1900 Frontage Rd Apt 810, Cherry Hill, NJ 08034-2214 | 2018-02-23 |
| 1457796930 | Galloway Pediatric Medical Day Care LLC | Clinic/Center | 66 West Jimmie Leeds Road, Absecon, NJ 08201 | 2013-05-09 |
| 1467650572 | Manchester Ped Day Hlth Svcs | Clinic/Center | 1770 Tobias Ave, Manchester, NJ 08759-5803 | 2007-07-10 |
| 1699828111 | Enam Corporation | Clinic/Center | 238 Mercer St, Gloucester City, NJ 08030-1429 | 2007-01-19 |
| 1245382555 | Horizon Pediatric Systems Inc. | Clinic/Center | 100 Youngs Rd, Suite 6, Mercerville, NJ 08619-1025 | 2007-01-17 |
| 1790871812 | Pediatric Day Hlth Ctr Gallow | Clinic/Center | 66 W Jimmie Leeds Rd, Galloway, NJ 08205-9401 | 2006-10-05 |
| 1104342856 | Epic Health Services, Inc | Clinic/Center | 316 W Westfield Ave, Roselle Park, NJ 07204-1841 | 2017-08-15 |
| 1154872240 | Little Stars Children's Medical Day Care LLC | Clinic/Center | 225 N Center Dr, North Brunswick, NJ 08902-4247 | 2016-10-24 |
| 1699167585 | Rainbow Children's Medical Day Care LLC | Clinic/Center | 100 Youngs Rd, Suite 100, Mercerville, NJ 08619-1025 | 2015-03-02 |
| 1265857890 | Manchester Pediatric Medical Day Care | Clinic/Center | 1770 Tobias Ave, Manchester, NJ 08759-5803 | 2014-02-18 |
| Find all providers with the same taxonomy | ||||
| City | ATLANTIC CITY |
| Zip Code | 08401 |
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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.