Individual
DR. DIANE GLORIA VERGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13-21 PLAZA RD, FAIR LAWN, NJ 07410-3311
(201) 791-2900
(201) 791-3241
Mailing address
1868 HOOPER AVE, TOMS RIVER, NJ 08753-8175
(848) 223-7120
(732) 349-6919
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA04904700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3368807-01
—
NJ
Enumeration date
02/15/2007
Last updated
07/27/2017
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