Individual
JAIME JESUS DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7600 RIVER RD, NORTH BERGEN, NJ 07047-6217
(201) 710-2756
Mailing address
80 BELAIRE CT, MATAWAN, NJ 07747-1120
(609) 805-6964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA11280000
NJ
Other
Enumeration date
03/18/2019
Last updated
06/22/2022
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