Organization
A&S GENERAL PHYSICIAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL R DE LA CRUZ MD (OWNER)
(973) 773-0303
Entity
Organization
Contact information
Practice address
1137 MAIN AVE, CLIFTON, NJ 07011-2386
(973) 773-0303
(973) 773-0004
Mailing address
1137 MAIN AVE, CLIFTON, NJ 07011-2386
(973) 773-0303
(973) 773-0004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300161
—
NJ
Enumeration date
09/21/2012
Last updated
01/12/2016
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