Organization
CATHEDRAL PHYSICIAN GROUP, PC
Active
Parent organization
SAINT MICHAELS MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAINT MICHAELS MEDICAL CENTER
Authorized official
LUIS BENDEZU MD (PHYSICIAN)
(973) 877-5188
Entity
Organization
Contact information
Practice address
1160 RAYMOND BLVD, 8TH FLOOR - PHYSICIAN SERVICES, NEWARK, NJ 07102-4168
(973) 491-2958
Mailing address
111 CENTRAL AVE, 1ST FLOOR, NEWARK, NJ 07102-1909
(973) 877-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NJ
Enumeration date
07/24/2007
Last updated
07/24/2007
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