Individual
DR. RICHARD J DEGROOTE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 923-7100
(732) 923-7104
Mailing address
PO BOX 8000, DEPT 601, BUFFALO, NY 14267-0002
(866) 295-0041
(708) 342-2517
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA03004300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1859102
—
NJ
Enumeration date
05/09/2006
Last updated
11/08/2011
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