Provider Demographics
NPI:1265968440
Name:INTEGRAL CARE PEDIATRICS LLC
Entity type:Organization
Organization Name:INTEGRAL CARE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:TURIZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-233-5494
Mailing Address - Street 1:562 KINGSLAND ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1069
Mailing Address - Country:US
Mailing Address - Phone:973-235-0101
Mailing Address - Fax:973-667-5716
Practice Address - Street 1:562 KINGSLAND ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1069
Practice Address - Country:US
Practice Address - Phone:973-235-0101
Practice Address - Fax:973-667-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08207300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty