Individual
DR. EDWIN RYAN RACELA SISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 PATERSON STREET, SUITE 3100, NEW BRUNSWICK, NJ 08901-1962
(732) 235-7827
(732) 235-6131
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
232550
MA
207L00000X
Anesthesiology Physician
Primary
25MA08958900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0273155
—
NJ
Enumeration date
06/15/2008
Last updated
10/13/2011
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