The Next Step in Quality Pediatric Health Care

Emergency? Call us 24 hours a day: (201) 666-1001

Call Us:    Old Tappan:  (201) 666-1001  •  Fax: (201) 666-7610

                    Bergenfield: (201) 385-7300  •  Fax: (201) 385-4748

Privacy & Non-discrimination Pay Your Bill Online Visit Your Patient Portal

Forms & Policies

Registration forms:

Filling out these sheets ahead of time will save you time during your first visit to the office.

Patient Demographics Sheet

Medical Insurance Form

 

Record Release Form:

To obtain records from another practice or hospital, click here:

 

Policies:

HIPAA Privacy Policy Notice

Financial Policies

Payment Policies

Insurance Plans

BCD Insurance List
Additional Insurance Plans
Amerigroup
Emblem (Only with Qualcare 
Plans)
Old Tappan Pediatrics

— Recent Posts —

Locations

  • 215 Old Tappan Rd.
  • Old Tappan, NJ 07675
  • P: (201) 666-1001
  • F: (201) 666-7610
  • Our Hours
  • 136 N. Washington Avenue
  • Bergenfield, NJ 07621
  • P: (201) 385-7300
  • F: (201) 385-4748

Copyright © 2018,  Old Tappan Pediatrics . All Rights Reserved .