Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric and Adolescent Medicine

Organization Pediatric Adolescent Medicine Physician · NPI 1053461855

Pediatric and Adolescent Medicine is a Pediatric Adolescent Medicine Physician in West Long Branch, New Jersey. Licensed in New Jersey. Registered with an NPI since 2007.

Licensed in
NJ
In the registry since
2007
Specialties on file
2

Practice location Address checks out

223 Monmouth Rd
West Long Branch, NJ 07764-1029
Phone: (732) 229-4540
Fax: (732) 229-8689
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X · Licence MA37398 (NJ)
Pediatric Adolescent Medicine Physician Taxonomy 2080A0000X · Licence MA040400 (NJ)

Record details

NPI number1053461855
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Maureen Kingsley — Office Mng · (732) 229-4540
NPI enumeratedJanuary 12, 2007
Last updated in NPPESAugust 22, 2020
Mailing address223 Monmouth Rd, West Long Branch, NJ 07764-1029