Organization
GARDEN STATE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SONIA DEORA D.O. (PHYSICIAN/OWNER)
(732) 274-1274
Entity
Organization
Contact information
Practice address
1002 AMBOY AVE., EDISON, NJ 08837
(732) 274-1274
(732) 355-0321
Mailing address
1002 AMBOY AVE., EDISON, NJ 08837
(732) 274-1274
(732) 355-0321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MB06893200
NJ
207R00000X
Internal Medicine Physician
Primary
25MA06750500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0189057
—
NJ
Enumeration date
10/18/2010
Last updated
04/30/2013
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