Organization
CENTER FOR DIAGNOSIS AND TREATMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS MARCELO BENALCAZAR M.D. (MEDICAL DIRECTOR)
(908) 353-3626
Entity
Organization
Contact information
Practice address
624 NEWARK AVE, ELIZABETH, NJ 07208-3539
(908) 353-3626
(908) 353-3625
Mailing address
624 NEWARK AVE, ELIZABETH, NJ 07208-3539
(908) 353-3626
(908) 353-3625
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07504600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028410
—
NJ
05
—
0272388
—
NJ
01
—
075232U87
PHYSICIAN RENDERING NUMBE
NJ
Enumeration date
03/19/2007
Last updated
03/17/2018
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