Individual
MANUEL LOPEZ BORJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 PALISADE AVE, JERSEY CITY, NJ 07306-1112
(201) 792-3612
Mailing address
59 TRAUTWEIN CRES, CLOSTER, NJ 07624-2935
(201) 768-4806
(201) 963-0011
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA41473
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3943607
—
NJ
Enumeration date
06/10/2006
Last updated
03/14/2012
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