Organization
PONZIO MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALYN MICHELLE PONZIO M.D. (OWNER)
(973) 783-0073
Entity
Organization
Contact information
Practice address
127 PINE ST, SUITE 10, MONTCLAIR, NJ 07042-4855
(973) 783-0073
(973) 783-4010
Mailing address
127 PINE ST, SUITE 10, MONTCLAIR, NJ 07042-4855
(973) 783-0073
(973) 783-4010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07671800
NJ
207RC0000X
Cardiovascular Disease Physician
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Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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