Organization
CENTRO MEDICO IBEROAMERICANO INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMON ANTONIO SANDOVAL M.D. (OWNER)
(973) 684-8138
Entity
Organization
Contact information
Practice address
416 PARK AVE, PATERSON, NJ 07504-1930
(973) 684-8138
(973) 684-0032
Mailing address
416 PARK AVE, PATERSON, NJ 07504-1930
(973) 684-8138
(973) 684-0032
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055488
HORIZON NJ HEALTH
—
05
—
6051308
—
NJ
01
—
F73229
UPIN
—
Enumeration date
10/24/2007
Last updated
12/19/2011
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