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Organization
SALUS MED PC
Active
Organization
SALUS MED PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND MANZANO VILLONGCO M.D, (CEO)
(732) 329-1257
Entity
Organization
Contact information
Practice address
121 CEDAR LN, SUITE2B, TEANECK, NJ 07666-4457
(732) 485-6874
Mailing address
7 TANNER DR, PRINCETON, NJ 08540-9488
(732) 329-1257
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07738300
NJ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
25MA07738300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01722150
—
NY
Enumeration date
02/05/2007
Last updated
01/04/2013
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