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Organization

THE KIDNEY GROUP PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM RICHARD CHENITZ M.D. (PRESIDENT)
(973) 624-4908
Entity
Organization

Contact information

Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 624-4908
(973) 877-5595
Mailing address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5595

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2824701
NJ
Enumeration date
03/04/2008
Last updated
04/03/2008
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