Individual
DR. JULIAN ENTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
268 MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-2011
(973) 877-5034
(973) 877-5231
Mailing address
PO BOX 1593, SECAUCUS, NJ 07096-1593
(201) 635-1003
(201) 635-1332
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA31753
NJ
207L00000X
Anesthesiology Physician
Primary
25MA03175300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0358801
—
NJ
Enumeration date
07/07/2005
Last updated
07/22/2013
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