Organization
DRC360, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY RICHARD CAVAZOS (OWNER)
(973) 452-9078
Entity
Organization
Contact information
Practice address
29 SOUTH ST, NEW PROVIDENCE, NJ 07974-2934
(973) 452-9078
Mailing address
29 SOUTH ST, NEW PROVIDENCE, NJ 07974-2934
(973) 452-9078
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
02/11/2015
Last updated
02/11/2015
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