Individual
DR. CORNEL MIRCEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 HIGHLAND AVE, SUITE 104, GLEN RIDGE, NJ 07028-1527
(973) 689-5522
Mailing address
123 HIGHLAND AVE, SUITE 104, GLEN RIDGE, NJ 07028-1527
(973) 680-5522
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA065118
NJ
207R00000X
Internal Medicine Physician
Primary
25MA06511800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7458100
—
NJ
Enumeration date
08/25/2006
Last updated
01/14/2020
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