OrganizationActive
Pediatric Surgery Group, LLC
NPI 1679580781 · Pediatric Surgery Physician · Maplewood, NJ
Provider details
- NPI number
- 1679580781
- Entity type
- Organization
- Primary specialty
- Pediatric Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Colin Bethel, Managing Member(973) 660-9334
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2130 Millburn Ave
Maplewood, NJ 07040-3725
Phone: (973) 313-3115
Fax: (973) 313-3188
Approximate (ZIP-level) locationGet directions
Mailing address
25b Vreeland Rd
Florham Park, NJ 07932-1900
Registry dates
- Enumerated
- 2006-08-02
- Last updated
- 2010-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.