Organization
EDGARDO C VALLEJO INC
Active
Other names
Edgardo Vallejo MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGARDO C VALLEJO M.D. (PRESIDENT)
(908) 352-1173
Entity
Organization
Contact information
Practice address
240 WILLIAMSON ST, SUITE 502, ELIZABETH, NJ 07202-3674
(908) 352-1173
(908) 352-0665
Mailing address
240 WILLIAMSON ST, SUITE 502, ELIZABETH, NJ 07202-3674
(908) 352-1173
(908) 352-0665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03310600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1709801
—
NJ
Enumeration date
07/29/2010
Last updated
07/29/2010
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