Organization
UNIVERSITY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WIRACHIN HOONPONGSIMANONT M.D. (PGY 2)
(973) 972-9261
Entity
Organization
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-9261
Mailing address
116 PLYMOUTH AVE., MAPLEWOOD, NJ 07040
(862) 216-0466
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
12/11/2008
Last updated
12/11/2008
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