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Individual

MICHELLE ANTONOWICZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6000
Mailing address
28 SUNSET DR, NORTH CALDWELL, NJ 07006-4750
(973) 396-8490

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA07150800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
045292
MEDICARE
NJ
05
8398607
NJ
Enumeration date
07/19/2005
Last updated
05/18/2008
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