Organization
THE CONNIE DWYER BREAST CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA HARPER (BILLING REPRESENTATIVE)
(201) 996-4053
Entity
Organization
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5189
(973) 877-5205
Mailing address
PO BOX 2047, SOUTH HACKENSACK, NJ 07606-0647
(201) 968-9456
(201) 336-8198
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA02784400
NJ
208600000X
Surgery Physician
Primary
25MA07666200
NJ
Other
Enumeration date
03/01/2007
Last updated
09/11/2025
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