Organization
CARLOS SACRISTAN, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS SACRISTAN M.D. (CEO)
(973) 473-4399
Entity
Organization
Contact information
Practice address
17-19 HOWE AVE, PASSAIC, NJ 07055-4017
(973) 473-4399
(973) 473-4430
Mailing address
17-19 HOWE AVE, PASSAIC, NJ 07055-4017
(973) 473-4399
(973) 473-4430
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7255306
—
NJ
Enumeration date
06/17/2011
Last updated
06/17/2011
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