Individual
ROSENIO R MEDENILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 ROUTE 72 W, SUITE 240, MANAHAWKIN, NJ 08050-2417
(609) 597-7394
(609) 597-6833
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA67504
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223016655
TAX ID
NJ
05
—
MA67504
—
NJ
Enumeration date
10/19/2006
Last updated
11/21/2024
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