Individual
DR. SOMCHAI KULWATDANAPORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
645 BROADWAY, PATERSON, NJ 07514-1926
(201) 962-8536
(201) 962-8536
Mailing address
645 BROADWAY, PATERSON, NJ 07514-1926
(973) 742-2077
(973) 653-3585
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MA035607
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
449091
MEDICARE
NJ
Enumeration date
04/19/2007
Last updated
05/18/2009
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