Individual
DR. JONATHAN BRETT WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
254 EASTON AVE, NEW BRUNSWICK, NJ 08901-1766
(732) 745-8590
Mailing address
254 EASTON AVE, NEW BRUNSWICK, NJ 08901-1766
(732) 745-8590
(732) 483-4824
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
273533-1
NY
Other
Enumeration date
09/06/2012
Last updated
01/15/2019
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