Individual
CHERYL BUENSUCESO PANEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5301 BROADWAY, WEST NEW YORK, NJ 07093-2622
(201) 866-9320
(201) 867-9183
Mailing address
98 ROMAINE AVE, JERSEY CITY, NJ 07306-5302
(201) 963-6706
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA07821400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066478
—
NJ
Enumeration date
06/19/2006
Last updated
07/08/2007
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