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Organization
NORTHEAST HEALTHCARE ASSOCIATES, LLC
Active
Organization
NORTHEAST HEALTHCARE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELSON MEDRANO (DIRECTOR)
(177) 079-2027
Entity
Organization
Contact information
Practice address
220 MARKET ST, PERTH AMBOY, NJ 08861-4331
(770) 874-1122
(770) 792-7893
Mailing address
PO BOX 6881, MARIETTA, GA 30065-0881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA05369700
NJ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
25MA06683000
NJ
207V00000X
Obstetrics & Gynecology Physician
25MA04247500
NJ
208D00000X
General Practice Physician
25MA02420000
NJ
Other
Enumeration date
04/09/2010
Last updated
04/09/2010
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