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VINELAND PEDIATRICS PA
NPI 1104937259
Pediatrics in Vineland, NJ

Active since August 31, 2006
1138 E CHESTNUT AVE #5B, VINELAND, NJ 08360(856) 692-1108(856) 692-2077 Get Directions Write a Review

NPPES record last updated: July 16, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vineland Pediatrics Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VINELAND PEDIATRICS PA (NPI 1104937259) is a healthcare organization registered as a pediatrics in Vineland, New Jersey and active in the NPI registry since August 2006. The organization lists Deborah L Mcmaster, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1104937259
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameVINELAND PEDIATRICS PA
Location Address1138 E CHESTNUT AVE #5BVineland, NJ 08360-5062
Mailing Address1138 E Chestnut Ave #5bVineland, NJ 08360-5062 · (856) 692-1108 · Fax (856) 692-2077
Phone(856) 692-1108
Fax(856) 692-2077
Organization SubpartNo
Authorized OfficialDeborah L McmasterOffice Manager · (856) 692-1108
Enumeration DateAugust 31, 2006
Last NPPES UpdateJuly 16, 2010
✔ NPI 1104937259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1138 E CHESTNUT AVE #5B, Vineland, NJ 08360
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Other Identifiers 8

Medicaid3394603NJ
OtherF03778Physicians Health
Other3041Aetna
OtherE337Amerigroup
Medicare ID-Type UnspecifiedV1679080NJ
Other679080Amerihealth
Other0513129001Amerihealth Hippa
Other1043187NJ · Horizon Health

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D0121026

Vineland Pediatrics PA · Vineland, NJ
Expired · Aug 6, 2026
CLIA Number31D0121026
Laboratory TypePhysician Office
Certificate Effective DateAugust 7, 2024
Certificate Expiration DateAugust 6, 2026
Laboratory DirectorOlabode Ogidan
Laboratory Phone(856) 692-1108
Laboratory LocationVineland Pediatrics PA1138 E Chestnut Ave, Suite # 5B, Vineland, NJ 08360
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vineland Pediatrics PA's NPI number?

The NPI number for Vineland Pediatrics PA is 1104937259. It was assigned to this organization in the NPPES registry on August 31, 2006.

Where is Vineland Pediatrics PA located?

Vineland Pediatrics PA is located at 1138 E Chestnut Ave #5b, Vineland, NJ 08360. The listed phone number is (856) 692-1108.

What is Vineland Pediatrics PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Vineland Pediatrics PA was last updated on July 16, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.