# NEW JERSEY TRAVEL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699116392
- **Authorized official:** JACQUELINE M. VIERHEILIG M.D. (PHYSICIAN)
- **Authorized official phone:** (201) 345-4550

## Contact information

- **Practice address:** 205 BROWERTOWN RD, SUITE \#202, WOODLAND PARK, NJ 07424-2671
- **Practice address phone:** (201) 345-4550
- **Mailing address:** PO BOX 1, MIDLAND PARK, NJ 07432-0001
- **Mailing address phone:** (201) 345-4550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 25MA06298300 | NJ | Yes |

## Other

- **Enumeration date:** 07/10/2013
- **Last updated:** 07/10/2013