Organization
JESUS ALFONSO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESUS ALFONSO MD (OWNER)
(201) 330-8747
Entity
Organization
Contact information
Practice address
7907 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4137
(201) 330-8747
(201) 330-8947
Mailing address
7907 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4137
(201) 330-8747
(201) 330-8947
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA05064100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JA3410307
—
NJ
Enumeration date
11/07/2007
Last updated
11/07/2007
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