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Organization
DEWI S. SUDJONO-SANTOSO
Active
Organization
DEWI S. SUDJONO-SANTOSO
Active
Parent organization
DEWI S. SUDJONO-SANTOSO
Other names
same as above
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEWI S. SUDJONO-SANTOSO
Authorized official
DR. DEWI S SUDJONO-SANTOSO MD (OWNER)
(609) 918-1030
Entity
Organization
Contact information
Practice address
339 PRINCETON-HIGHTSTOWN RD, BUILDING B, CRANBURY, NJ 08512
(609) 918-1030
(609) 918-1322
Mailing address
339 PRINCETON-HIGHTSTOWN RD, BUILDING B, CRANBURY, NJ 08512
(609) 918-1030
(609) 918-1322
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MA01513300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053342865
—
NJ
Enumeration date
01/21/2015
Last updated
01/21/2015
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