Organization
SOMATUS WHOLE CARE CENTER OF NEW JERSEY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN KO MD (AUTHORIZED OFFICIAL)
(571) 244-7441
Entity
Organization
Contact information
Practice address
1861 INTERNATIONAL DRIVE, STE 600, MCLEAN, VA 22102-4420
(571) 992-0600
Mailing address
1861 INTERNATIONAL DRIVE, STE 600, MCLEAN, VA 22102-4420
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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