Individual
BERTHA MAYORQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
377 JERSEY AVE, SUITE 470, JERSEY CITY, NJ 07302-0000
(201) 918-2239
(201) 918-2243
Mailing address
PO BOX 1557, LIVINGSTON, NJ 07039-7157
(201) 918-2239
(201) 918-2243
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA08638600
NJ
207R00000X
Internal Medicine Physician
Primary
25MA08638600
NJ
Other
Enumeration date
02/11/2010
Last updated
07/26/2011
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