Organization
UMDNJ-RWJ MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE GREEN (APN)
(732) 235-6423
Entity
Organization
Contact information
Practice address
125 PATERSON ST, 6176, NEW BRUNSWICK, NJ 08901-1962
(732) 235-6423
(732) 235-6530
Mailing address
125 PATERSON ST, 6176, NEW BRUNSWICK, NJ 08901-1962
(732) 235-6423
(732) 235-6530
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
26NJ00007600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300195
—
NJ
Enumeration date
06/18/2012
Last updated
03/25/2013
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