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Organization

EDISON FAMILY PRACTICE

Active
Other names
Edison Family Practice PC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARIA S FLORES DIEPPA MD (OWNER)
(732) 548-6303
Entity
Organization

Contact information

Practice address
616 GROVE AVE, EDISON, NJ 08820-3212
(732) 548-6303
(732) 549-4676
Mailing address
616 GROVE AVE, EDISON, NJ 08820-3212
(732) 548-6303
(732) 549-4676

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA45007
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
25MAO4500700ANI
NJ
Enumeration date
10/26/2011
Last updated
01/11/2012
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