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Organization

SPARTACO BELLOMO M.D.P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SOPHIE CISZEWSKI R.N. (OFFICE MANAGER)
(201) 653-8336
Entity
Organization

Contact information

Practice address
142 PALISADE AVE, SUITE 209, JERSEY CITY, NJ 07306-1133
(201) 653-8336
(201) 653-6697
Mailing address
142 PALISADE AVENUE, SUITE 209, JERSEY CITY, NJ 07306-1108
(201) 653-8336
(201) 653-6697

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA03988000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1425706
NJ
Enumeration date
12/20/2010
Last updated
12/20/2010
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