Individual
DR. JESUS ROBERTO ALFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 PARK AVE, WEEHAWKEN, NJ 07086-7210
(201) 330-8747
(201) 330-8947
Mailing address
4800 PARK AVE, WEEHAWKEN, NJ 07086-7210
(201) 330-8747
(201) 330-8947
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA05064100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410307
—
NJ
Enumeration date
09/22/2005
Last updated
01/12/2017
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