| Organization Name: | MEJIA PEDIATRICS LLC |
| NPI Number: | 1043507270 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHANNA J GONZALEZ MEJIA (OWNER) |
| Mailing Address: | 433 N Broad St Elizabeth |
| State: | NJ US |
| Postal Code: | 072083300 |
| Phone Number: | 9084361002 |
| Fax Number: | 9084361109 |
| NPI Enumeration Date: | 07/08/2011 |
| NPI Last Update Date: | 07/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 1428465 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |