COLLEGE PLAZA PEDIATRICS
NPI 1417083403
Pediatrics in Randolph, NJ

Q: What is College Plaza Pediatrics's NPI number?

The NPI number for College Plaza Pediatrics is 1417083403. It was assigned to this organization in the NPPES registry on February 26, 2007.

Q: What is College Plaza Pediatrics's specialty?

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

Active since February 26, 2007CLIA 31D2023866 · Waiver

765 ROUTE 10 EAST, SUITE 203, RANDOLPH, NJ 07869(973) 659-9991(973) 659-9632 Get Directions Write a Review

NPPES record last updated: May 22, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About College Plaza Pediatrics NPPES

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

COLLEGE PLAZA PEDIATRICS (NPI 1417083403) is a healthcare organization registered as a pediatrics in Randolph, New Jersey and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Julio C Guerra, Owner, as its authorized official.

NPPES Registry Identity

NPI1417083403

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameCOLLEGE PLAZA PEDIATRICS

Location Address765 ROUTE 10 EAST, SUITE 203Randolph, NJ 07869-1925

Mailing Address765 Route 10 East, Suite 203Randolph, NJ 07869-1925 · (973) 659-9991 · Fax (973) 659-9632

Phone(973) 659-9991

Fax(973) 659-9632

Organization SubpartNo

Authorized OfficialJulio C GuerraOwner · (973) 659-9991

Enumeration DateFebruary 26, 2007

Last NPPES UpdateMay 22, 2012

✔ NPI 1417083403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in NJ · MA057052

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.

765 ROUTE 10 EAST, Randolph, NJ 07869

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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 31D2023866

College Plaza Pediatrics · Randolph, NJ

Active · expires May 3, 2027

CLIA Number31D2023866

Laboratory TypePhysician Office

Certificate Effective DateMay 4, 2025

Certificate Expiration DateMay 3, 2027

Laboratory DirectorJulio Guerra

Laboratory Phone(973) 659-9991

Laboratory LocationCollege Plaza Pediatrics765 Route 10 East Ste 203, Randolph, NJ 07869

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. STEPHEN J WILLIAMS M.D.