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Organization

C AND M KINTIROGLOU MD'S PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BRIGETTE FULLARD (OFFICE MANAGER)
(973) 243-0002
Entity
Organization

Contact information

Practice address
1500 PLEASANT VALLEY WAY, SUITE 301, WEST ORANGE, NJ 07052-2956
(973) 243-0002
Mailing address
1500 PLEASANT VALLEY WAY, SUITE 301, WEST ORANGE, NJ 07052-2956

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA03124000
NJ

Other

Enumeration date
06/10/2011
Last updated
06/10/2011
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