Provider Demographics
NPI:1306904503
Name:CHILDRENS EMERGENCY SERVICES INC
Entity type:Organization
Organization Name:CHILDRENS EMERGENCY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ISTVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-686-4316
Mailing Address - Street 1:307 S. EVERGREEN AVENUE
Mailing Address - Street 2:CHILDRENS EMERGENCY SERVICES INC
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2936
Mailing Address - Country:US
Mailing Address - Phone:856-686-4316
Mailing Address - Fax:865-291-3254
Practice Address - Street 1:1 CHILDRENS PLZ
Practice Address - Street 2:CHILDRENS EMERGENCY SERVICE INC
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404
Practice Address - Country:US
Practice Address - Phone:856-686-4316
Practice Address - Fax:865-291-3254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH525169207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0785600Medicaid
OH310945237906OtherGROUP BCBS
OH0785600Medicaid