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Organization
VALLEY CENTER FOR FAMILY MEDICINE PC
Active
Organization
VALLEY CENTER FOR FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE MUCCINO (OFFICE MGR)
(973) 940-0512
Entity
Organization
Contact information
Practice address
14 VIOLET TRL, LAFAYETTE, NJ 07848-2203
(973) 940-0512
Mailing address
14 VIOLET TRL, LAFAYETTE, NJ 07848-2203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA035277
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1163604
—
NJ
Enumeration date
01/22/2007
Last updated
11/29/2011
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