Organization
COLON AND RECTAL SPECIALISTS,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARJAN ALEALI M.D. (PRESIDENT)
(203) 913-7677
Entity
Organization
Contact information
Practice address
255 W SPRING VALLEY AVE, SUITE 103, MAYWOOD, NJ 07607-1445
(201) 525-1031
(201) 880-4560
Mailing address
255 W SPRING VALLEY AVE, SUITE 103, MAYWOOD, NJ 07607-1445
(201) 525-1031
(201) 880-4560
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064693
MEDICARE ID
—
Enumeration date
03/09/2011
Last updated
03/09/2011
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