Individual
CARLOS ALFONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
946 BLOOMFIELD AVENUE, GLEN RIDGE, NJ 07028
(973) 743-1121
(973) 743-2627
Mailing address
946 BLOOMFIELD AVENUE, GLEN RIDGE, NJ 07028
(973) 743-1121
(973) 743-2627
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MA06865300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MA06865300
—
NJ
Enumeration date
03/14/2006
Last updated
06/24/2010
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