Organization
A SULSE M. D. PROF ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCEDES CORONADO (OFFICE MANAGER)
(732) 634-6188
Entity
Organization
Contact information
Practice address
423 AMBOY AVE, WOODBRIDGE, NJ 07095-2909
(732) 634-6188
(908) 769-0945
Mailing address
423 AMBOY AVE, WOODBRIDGE, NJ 07095-2909
(732) 634-6188
(908) 769-0945
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA02311900
NJ
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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