Rivendell Pediatric and Adolscent Medicine, PC

NPI #1497797864 in Columbus, New Jersey

Provider Information

NPI Number: 1497797864
Entity Type: Organization
Organization Name: Rivendell Pediatric and Adolscent Medicine, PC
Primary Specialty: Pediatrics
Enumeration Date: Jun 12, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 25 HOMESTEAD DR
Address 2: STE H
City: Columbus
State: New Jersey
ZIP Code: 08022-1005
Phone: (609) 424-0340

Authorized Official

Name: DR. KENNETH MICHAEL HIRSCH, MD
Title: MD/PRES
Phone: (609) 424-0340

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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