Organization
MARY DAISY CANTEY MD CAROLINA MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY DAISY CANTEY MD (OWNER)
(973) 532-7898
Entity
Organization
Contact information
Practice address
312 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2502
(973) 532-7898
(973) 821-5999
Mailing address
312 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2502
(973) 532-7898
(973) 821-5999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07425300
NJ
208000000X
Pediatrics Physician
25MA07425300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8941106
—
NJ
Enumeration date
07/20/2015
Last updated
08/18/2015
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