Organization
MARIO E PELLETIER MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO E PELLETIER MD (OWNER)
(201) 869-6868
Entity
Organization
Contact information
Practice address
6003 MONROE PL, SUITE 1A, WEST NEW YORK, NJ 07093-5440
(201) 869-6868
Mailing address
6003 MONROE PL, SUITE 1A, WEST NEW YORK, NJ 07093-5440
(201) 869-6868
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MA04256000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2324105
—
NJ
Enumeration date
05/08/2008
Last updated
05/18/2008
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