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Individual

DR. DEWI S SUDJONO-SANTOSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MEDICAL DOCTOR

Contact information

Practice address
251 PRINCETON HIGHTOWN RD, HIGHTSTOWN, NJ 08520
(609) 448-1421
(609) 395-1978
Mailing address
251 PRINCETON HIGHTOWN RD, HIGHTSTOWN, NJ 08520
(609) 448-1421
(609) 395-1978

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MA06441900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0404226610
AMERHLTH HMO
01
249850
UNHC
01
2K0986
HEALTH NET
01
3134649
CIGNA
01
36701
AETNA HMO
01
385405
AMERHLTH PPO
01
4058994
AETNA PPO
01
82836
AMERGRP
01
MEP135
OXFORD
Enumeration date
07/06/2006
Last updated
07/08/2007
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