Organization
PRIMARY MEDICAL CARE PROFESSIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH SALESE MD (PRESIDENT)
(973) 673-9229
Entity
Organization
Contact information
Practice address
85 S JEFFERSON ST, STE. 3, ORANGE, NJ 07050-1562
(973) 673-9229
(973) 673-0018
Mailing address
85 S JEFFERSON ST, STE.1, ORANGE, NJ 07050-1562
(973) 677-3466
(973) 677-2362
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6874509
—
NJ
01
—
CJ6915
RAILROAD MEDICARE
—
Enumeration date
07/25/2006
Last updated
10/07/2010
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