Organization
PORTEJAS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIA PORTELA (OWNER)
(201) 867-6705
Entity
Organization
Contact information
Practice address
4207 BERGENLINE AVE, UNION CITY, NJ 07087-4896
(201) 867-6705
(201) 867-3758
Mailing address
4207 BERGENLINE AVE, UNION CITY, NJ 07087-4896
(201) 867-6705
(201) 867-3758
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00542500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2056801
PK
—
05
—
7305001
—
NJ
Enumeration date
10/26/2006
Last updated
11/16/2021
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