Individual
GEOFFREY WAMBUA T. NDETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1945 STATE ROUTE 33, NEPTUNE, NJ 07753-4859
(732) 897-0200
(732) 897-0263
Mailing address
PO BOX 307, NEPTUNE, NJ 07754-0307
(732) 897-0200
(732) 897-0263
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA5757700
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MA05757700
NJ
208VP0014X
Interventional Pain Medicine Physician
25MA05757700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6766005
—
NJ
Enumeration date
07/14/2006
Last updated
10/20/2011
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