Organization
CENTER FOR PREVENTATIVE MEDICINE OF NEW JERSEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN D HOLDER MD (OWNER)
(973) 762-6077
Entity
Organization
Contact information
Practice address
5 STANLEY RD, SOUTH ORANGE, NJ 07079-2721
(973) 762-6077
Mailing address
5 STANLEY RD, SOUTH ORANGE, NJ 07079-2721
(973) 762-6077
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA04662500
NJ
207R00000X
Internal Medicine Physician
Primary
25MA04002500
NJ
Other
Enumeration date
03/14/2007
Last updated
04/16/2013
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