Organization
590 MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD M VERNON DO (MEDICAL DIRECTOR)
(201) 420-1165
Entity
Organization
Contact information
Practice address
590 NEWARK AVE, JERSEY CITY, NJ 07306-2302
(201) 420-1165
(201) 420-6893
Mailing address
590 NEWARK AVE, JERSEY CITY, NJ 07306-2302
(201) 420-1165
(201) 420-6893
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NJ
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
NJ
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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