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Organization

ESSEX PEDIDOC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BERNIER LAUREDAN MD (PHYSICIAN)
(973) 371-1600
Entity
Organization

Contact information

Practice address
22 BALL ST STE 100, IRVINGTON, NJ 07111-3521
(973) 371-1600
Mailing address
22 BALL ST STE 100, IRVINGTON, NJ 07111-3521
(973) 371-1600

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
25MA05388700
NJ

Other

Enumeration date
06/24/2011
Last updated
06/24/2011
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