Organization
NEW JERSEY TRAVEL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE M. VIERHEILIG M.D. (PHYSICIAN)
(201) 345-4550
Entity
Organization
Contact information
Practice address
205 BROWERTOWN RD, SUITE #202, WOODLAND PARK, NJ 07424-2671
(201) 345-4550
Mailing address
PO BOX 1, MIDLAND PARK, NJ 07432-0001
(201) 345-4550
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
25MA06298300
NJ
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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