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Individual

DR. EDGARDO C VALLEJO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
240 WILLIAMSON ST, SUITE 502, ELIZABETH, NJ 07202
(908) 352-1173
(908) 352-0665
Mailing address
240 WILLIAMSON ST, SUITE 502, ELIZABETH, NJ 07202
(908) 352-1173
(908) 352-0665

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03310600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1709801
NJ
Enumeration date
10/02/2006
Last updated
06/28/2010
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