Individual
DR. VIVINA CORTEZA MALANTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21 BALDWIN AVE, JERSEY CITY, NJ 07304-3155
(201) 333-8830
Mailing address
387 LORETTA DR, ORADELL, NJ 07649-1836
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA02450800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60004980
HORIZON NJ HEALTH
NJ
Enumeration date
03/21/2007
Last updated
07/08/2007
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