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Organization

LUIS BENALCAZAR, MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LUIS BENALCAZAR M.D. (MEDICAL DIRECTOR)
(908) 353-3628
Entity
Organization

Contact information

Practice address
310 MORRIS AVE, SUITE 301, ELIZABETH, NJ 07208-3695
(908) 353-3628
(908) 353-3625
Mailing address
310 MORRIS AVE, SUITE 301, ELIZABETH, NJ 07208-3695
(908) 353-3628
(908) 353-3625

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07504600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0028410
NJ
01
075232SRA
CMS RENDERING NUMBER
NJ
Enumeration date
09/26/2007
Last updated
09/26/2007
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