Individual
MARY DAISY CANTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
90 BERGEN ST, NEWARK, NJ 07103-2425
(973) 972-6635
(973) 972-0956
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
(973) 972-1880
(973) 972-1879
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07425300
NJ
208000000X
Pediatrics Physician
25MA07425300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8941106
—
NJ
Enumeration date
03/07/2007
Last updated
06/08/2009
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